Navigation Links
American Heart Association Late Breaking Clinical Trial Report: Tests Predict Which Patients Are Resistant to Anti-Clotting Therapy During Angioplasty, Stenting
Date:11/15/2009

Study highlights:

-- Three of six platelet reactivity tests predicted a risk of adverse outcomes related to blood clots in patients receiving two anti-clotting drugs following angioplasty (PCI) plus stenting.

-- Three other tests failed to predict excess risk.

-- It may soon be practical to test every PCI-plus-stent patient's response to anti-platelet therapy.

ORLANDO, Fla., Nov. 15 /PRNewswire-USNewswire/ -- Three platelet function tests all identified heart patients who will have blood cells that remain sticky, increasing heart attack risk, despite being pre-treated with two anti-clotting medications before coronary stenting, researchers reported at the American Heart Association's Scientific Sessions 2009.

POPULAR (Do platelet function assays predict clinical outcomes in clopidogrel pre-treated patients undergoing elective PCI) is the first head-to-head comparison of tests for platelet reactivity (meaning the blood's likelihood to clot) despite anti-clotting medication.

Specifically, it examines which of the many tests available best predicts clot-related (thrombotic) complications, such as heart attack and stroke, in patients pre-treated with aspirin and clopidogrel who then undergo percutaneous coronary intervention (PCI) with stent implantation, said Jurrien M. ten Berg, M.D., Ph.D., an interventional cardiologist at St. Antonius Hospital, Nieuwegein, the Netherlands, and senior investigator of the study.

"Only a minority of centers routinely uses platelet reactivity testing to guide therapy, but it is used extensively as a research tool," he said. "I think we are on the brink of making platelet reactivity a clinical tool."

Dual antiplatelet therapy with aspirin and clopidogrel is used for its ability to reduce clot-related complications of PCI. But in some studies a significant number (30-40 percent) of patients are resistant to the treatment and are at risk of clot-related complications even after that treatment, said ten Berg.

Researchers haven't conducted a large study comparing the many tests that check platelet reactivity, said Nicoline J. Breet, M.D., presenter of the study and a Ph.D. fellow and cardiologist-in-training at St. Antonius Hospital.

In POPULAR, researchers compared six different tests of platelet reactivity in 1,069 consecutive patients undergoing angioplasty with stent placement and included one-year follow-up. The primary endpoint was a composite of all-cause death, heart attack, urgent revascularization, stroke or blood clots arising within the stent (stent thrombosis), ten Berg said.

Patients who had high platelet reactivity (HPR) on three of the tests -- the Light Transmittance Aggregometry (LTA), the VerifyNow-P2Y12®-cartridge and the Plateletworks(TM) assay -- had a significantly greater incidence of the combined primary endpoint (12.1 percent vs. 6 percent) at one year compared to patients who did not, ten Berg said. Three other tests evaluated didn't predict outcomes.

Of the three predictive tests, the LTA is the most labor-intensive and can't be performed at bedside, and Plateletworks(TM) must be done within 10 minutes of drawing blood, ten Berg said. The third test, VerifyNow-P2Y12® does not have those limitations, he said.

In conclusion, it is useful to test the response to antiplatelet therapy in all patients undergoing elective angioplasty plus stent placement to identify those patients at highest risk for clot-related complications," ten Berg said.

These results have not yet been extended to demonstrate that basing additional treatment(s) on the test results would improve patient outcomes in those at higher risk.

Study sponsor: The study received no funding. Siemens Healthcare Diagnostics provided the Dade® PFA Collagen/ADP Test Cartridge and the novel INNOVANCE® PFA P2Y* free-of-charge.

Co-authors are: Jochem W. van Werkum M.D., Ph.D.; Heleen J. Bouman MSc; Johannes C.

Kelder, M.D.; Henk J.T. Ruven, Ph.D.; Egbert T. Bal, M.D.; Vera H. Deneer, PharmD, Ph.D.; Ankie M. Harmsze, PharmD; Jan A.S. van der Heyden, M.D.; Benno J.W.M. Rensing, M.D., Ph.D.; Maarten J. Suttorp, M.D., Ph.D.; Christian M. Hackeng, Ph.D.; Jurrien M. ten Berg, M.D., Ph.D.

Disclosures: None related to this study.

Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding.

NR09 - 1159 (SS09/POPULAR / Breet and ten Berg)

SOURCE American Heart Association


'/>"/>
SOURCE American Heart Association
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Many Older Americans Have Active Sex Lives
2. Despite grumbling, most Americans say they are happy at work
3. Record Number of Americans Lack Health Insurance
4. Longaberger Expands Horizon of Hope Campaign to Build Support for American Cancer Societys Breast Cancer Initiatives
5. AUDIO from Medialink and Pfizer: Number of Uninsured Americans Grows to 47 Million
6. New Survey Shows Americans are Still Concerned About Food Safety, Yet Still Not Smart About What They Like to Eat
7. Novo Nordisk Appoints New Leader of North American Business
8. Amid Improving Life Expectancy Rates, Risk of Premature Death is Still Significant for Americans, New Study Shows
9. Primary biliary cirrhosis more severe in African-American and Hispanic patients
10. AOA President Calls on Congress to Reauthorize SCHIP and Take Action to Ensure Health Care Coverage for All Americans
11. American Chemical Societys Weekly Presspac -- Sept. 5, 2007
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... , ... June 24, 2016 , ... Marcy was in a crisis. Her son James, ... out at his family verbally and physically. , “When something upset him, he couldn’t control ... use it. He would throw rocks at my other children and say he was going ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Global law firm ... 2016 Legal Elite. The attorneys chosen by their peers for this recognition are considered ... Seven Greenberg Traurig Shareholders received special honors as members of this year’s Legal Elite ...
(Date:6/24/2016)... ... ... Comfort Keepers® of San Diego, CA is excited to announce they are ... drive cancer patients to and from their cancer treatments. Comfort Keepers provides quality ... and ongoing independence. Getting to and from medical treatments is one of the ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... People across ... in Genome magazine’s Code Talker Award, an essay contest in which patients and their ... award to be presented at the 2016 National Society of Genetic Counselors (NSGC) Annual ...
(Date:6/24/2016)... ... June 24, 2016 , ... The ... recognize Dr. Barry M. Weintraub as a prominent plastic surgeon and the network’s ... the world, and the most handsome men, look naturally attractive. Plastic surgery should ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... , June 26, 2016 ... care operating models within the health care industry is ... financial efficiency , Deloitte offers a suite of ... business issues impacting efficient cost optimization: labor resource analysis, ... These services facilitate better outcomes and better economics ...
(Date:6/24/2016)... SAN FRANCISCO, Calif. , June 24, 2016 ... GBT ), a biopharmaceutical company developing novel therapeutics ... significant unmet needs, today announced the closing of ... shares of common stock, at the public offering ... shares in the offering were offered by GBT. ...
(Date:6/24/2016)... DUBLIN , June 24, 2016 ... addition of the "Structural Electronics 2015-2025: Applications, ... In-Mold Electronics, Smart ... Integrated Photovoltaics Structural electronics involves ... as load-bearing, protective structures, replacing dumb structures such ...
Breaking Medicine Technology: