Effects of statin therapy on platelet reactivity after percutaneous coronary revascularization in patients with acute coronary syndrome

Anna Toso, Stefano De Servi, Mario Leoncini, Dominick J. Angiolillo, Paolo Calabrò, Federico Piscione, Marco Cattaneo, Diego Maffeo, Antonio Bartorelli, Cataldo Palmieri, Marco De Carlo, Davide Capodanno, Philippe Genereux, Francesco Bellandi, Chiara Barozzi, Luciana Tomasi, Diego Della Riva, Tullio Palmerini

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Statin use is associated with enhanced pharmacodynamic response to clopidogrel in patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI). However, the impact of statin therapy on clopidogrel response profiles in patients with acute coronary syndrome (ACS) undergoing PCI has not been established and represents the objective of this investigation. On-treatment P2Y12 platelet reactivity was measured using the vasodilator stimulated phosphoprotein (VASP) phosphorylation assay before PCI, at hospital discharge, and at 1 month after PCI in ACS patients enrolled in the multicenter, prospective GEne polymorphisms, Platelet Reactivity, and Syntax Score (GEPRESS) study (n = 962). High platelet reactivity (HPR) was defined as platelet reactivity index ≥50%. Statins were prescribed at hospital discharge in 87% (n = 835) of patients. All patients were followed for 1 year. The 1-month HPR rate was lower in statin than in non-statin treated patients (39.6 vs 52%, respectively, p = 0.009). This finding was confirmed also among statin-treated patients with high Syntax score (≥15). After adjustment for differences in baseline characteristics, statin use at discharge was independently associated with 1-month HPR rate (odds ratio, 0.58, 95% confidence interval, 0.38–0.89; p = 0.015). In ACS patients undergoing PCI treated with clopidogrel the use of statins at discharge was associated with significantly lower 1-month HPR rates compared with patients not treated with statins.

Original languageEnglish (US)
Pages (from-to)355-361
Number of pages7
JournalJournal of Thrombosis and Thrombolysis
Volume44
Issue number3
DOIs
StatePublished - Oct 1 2017

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Percutaneous Coronary Intervention
Acute Coronary Syndrome
Blood Platelets
clopidogrel
Therapeutics
Coronary Artery Disease
Odds Ratio
Phosphorylation
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Hematology
  • Cardiology and Cardiovascular Medicine

Cite this

Toso, Anna ; De Servi, Stefano ; Leoncini, Mario ; Angiolillo, Dominick J. ; Calabrò, Paolo ; Piscione, Federico ; Cattaneo, Marco ; Maffeo, Diego ; Bartorelli, Antonio ; Palmieri, Cataldo ; De Carlo, Marco ; Capodanno, Davide ; Genereux, Philippe ; Bellandi, Francesco ; Barozzi, Chiara ; Tomasi, Luciana ; Della Riva, Diego ; Palmerini, Tullio. / Effects of statin therapy on platelet reactivity after percutaneous coronary revascularization in patients with acute coronary syndrome. In: Journal of Thrombosis and Thrombolysis. 2017 ; Vol. 44, No. 3. pp. 355-361.
@article{1e1016cd8e1e47689c53562ce6096b65,
title = "Effects of statin therapy on platelet reactivity after percutaneous coronary revascularization in patients with acute coronary syndrome",
abstract = "Statin use is associated with enhanced pharmacodynamic response to clopidogrel in patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI). However, the impact of statin therapy on clopidogrel response profiles in patients with acute coronary syndrome (ACS) undergoing PCI has not been established and represents the objective of this investigation. On-treatment P2Y12 platelet reactivity was measured using the vasodilator stimulated phosphoprotein (VASP) phosphorylation assay before PCI, at hospital discharge, and at 1 month after PCI in ACS patients enrolled in the multicenter, prospective GEne polymorphisms, Platelet Reactivity, and Syntax Score (GEPRESS) study (n = 962). High platelet reactivity (HPR) was defined as platelet reactivity index ≥50{\%}. Statins were prescribed at hospital discharge in 87{\%} (n = 835) of patients. All patients were followed for 1 year. The 1-month HPR rate was lower in statin than in non-statin treated patients (39.6 vs 52{\%}, respectively, p = 0.009). This finding was confirmed also among statin-treated patients with high Syntax score (≥15). After adjustment for differences in baseline characteristics, statin use at discharge was independently associated with 1-month HPR rate (odds ratio, 0.58, 95{\%} confidence interval, 0.38–0.89; p = 0.015). In ACS patients undergoing PCI treated with clopidogrel the use of statins at discharge was associated with significantly lower 1-month HPR rates compared with patients not treated with statins.",
author = "Anna Toso and {De Servi}, Stefano and Mario Leoncini and Angiolillo, {Dominick J.} and Paolo Calabr{\`o} and Federico Piscione and Marco Cattaneo and Diego Maffeo and Antonio Bartorelli and Cataldo Palmieri and {De Carlo}, Marco and Davide Capodanno and Philippe Genereux and Francesco Bellandi and Chiara Barozzi and Luciana Tomasi and {Della Riva}, Diego and Tullio Palmerini",
year = "2017",
month = "10",
day = "1",
doi = "10.1007/s11239-017-1541-x",
language = "English (US)",
volume = "44",
pages = "355--361",
journal = "Journal of Thrombosis and Thrombolysis",
issn = "0929-5305",
publisher = "Springer Netherlands",
number = "3",

}

Toso, A, De Servi, S, Leoncini, M, Angiolillo, DJ, Calabrò, P, Piscione, F, Cattaneo, M, Maffeo, D, Bartorelli, A, Palmieri, C, De Carlo, M, Capodanno, D, Genereux, P, Bellandi, F, Barozzi, C, Tomasi, L, Della Riva, D & Palmerini, T 2017, 'Effects of statin therapy on platelet reactivity after percutaneous coronary revascularization in patients with acute coronary syndrome', Journal of Thrombosis and Thrombolysis, vol. 44, no. 3, pp. 355-361. https://doi.org/10.1007/s11239-017-1541-x

Effects of statin therapy on platelet reactivity after percutaneous coronary revascularization in patients with acute coronary syndrome. / Toso, Anna; De Servi, Stefano; Leoncini, Mario; Angiolillo, Dominick J.; Calabrò, Paolo; Piscione, Federico; Cattaneo, Marco; Maffeo, Diego; Bartorelli, Antonio; Palmieri, Cataldo; De Carlo, Marco; Capodanno, Davide; Genereux, Philippe; Bellandi, Francesco; Barozzi, Chiara; Tomasi, Luciana; Della Riva, Diego; Palmerini, Tullio.

In: Journal of Thrombosis and Thrombolysis, Vol. 44, No. 3, 01.10.2017, p. 355-361.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of statin therapy on platelet reactivity after percutaneous coronary revascularization in patients with acute coronary syndrome

AU - Toso, Anna

AU - De Servi, Stefano

AU - Leoncini, Mario

AU - Angiolillo, Dominick J.

AU - Calabrò, Paolo

AU - Piscione, Federico

AU - Cattaneo, Marco

AU - Maffeo, Diego

AU - Bartorelli, Antonio

AU - Palmieri, Cataldo

AU - De Carlo, Marco

AU - Capodanno, Davide

AU - Genereux, Philippe

AU - Bellandi, Francesco

AU - Barozzi, Chiara

AU - Tomasi, Luciana

AU - Della Riva, Diego

AU - Palmerini, Tullio

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Statin use is associated with enhanced pharmacodynamic response to clopidogrel in patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI). However, the impact of statin therapy on clopidogrel response profiles in patients with acute coronary syndrome (ACS) undergoing PCI has not been established and represents the objective of this investigation. On-treatment P2Y12 platelet reactivity was measured using the vasodilator stimulated phosphoprotein (VASP) phosphorylation assay before PCI, at hospital discharge, and at 1 month after PCI in ACS patients enrolled in the multicenter, prospective GEne polymorphisms, Platelet Reactivity, and Syntax Score (GEPRESS) study (n = 962). High platelet reactivity (HPR) was defined as platelet reactivity index ≥50%. Statins were prescribed at hospital discharge in 87% (n = 835) of patients. All patients were followed for 1 year. The 1-month HPR rate was lower in statin than in non-statin treated patients (39.6 vs 52%, respectively, p = 0.009). This finding was confirmed also among statin-treated patients with high Syntax score (≥15). After adjustment for differences in baseline characteristics, statin use at discharge was independently associated with 1-month HPR rate (odds ratio, 0.58, 95% confidence interval, 0.38–0.89; p = 0.015). In ACS patients undergoing PCI treated with clopidogrel the use of statins at discharge was associated with significantly lower 1-month HPR rates compared with patients not treated with statins.

AB - Statin use is associated with enhanced pharmacodynamic response to clopidogrel in patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI). However, the impact of statin therapy on clopidogrel response profiles in patients with acute coronary syndrome (ACS) undergoing PCI has not been established and represents the objective of this investigation. On-treatment P2Y12 platelet reactivity was measured using the vasodilator stimulated phosphoprotein (VASP) phosphorylation assay before PCI, at hospital discharge, and at 1 month after PCI in ACS patients enrolled in the multicenter, prospective GEne polymorphisms, Platelet Reactivity, and Syntax Score (GEPRESS) study (n = 962). High platelet reactivity (HPR) was defined as platelet reactivity index ≥50%. Statins were prescribed at hospital discharge in 87% (n = 835) of patients. All patients were followed for 1 year. The 1-month HPR rate was lower in statin than in non-statin treated patients (39.6 vs 52%, respectively, p = 0.009). This finding was confirmed also among statin-treated patients with high Syntax score (≥15). After adjustment for differences in baseline characteristics, statin use at discharge was independently associated with 1-month HPR rate (odds ratio, 0.58, 95% confidence interval, 0.38–0.89; p = 0.015). In ACS patients undergoing PCI treated with clopidogrel the use of statins at discharge was associated with significantly lower 1-month HPR rates compared with patients not treated with statins.

UR - http://www.scopus.com/inward/record.url?scp=85028321794&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028321794&partnerID=8YFLogxK

U2 - 10.1007/s11239-017-1541-x

DO - 10.1007/s11239-017-1541-x

M3 - Article

VL - 44

SP - 355

EP - 361

JO - Journal of Thrombosis and Thrombolysis

JF - Journal of Thrombosis and Thrombolysis

SN - 0929-5305

IS - 3

ER -