Impact of Obesity and the Metabolic Syndrome on Response to Clopidogrel or Prasugrel and Bleeding Risk in Patients Treated After Coronary Stenting

This study aimed to analyze the impact of body mass index (BMI) and the metabolic syndrome (MS) on responses to clopidogrel or prasugrel and bleeding risk after acute coronary syndrome. The study included 1,542 consecutive patients who underwent coronary stenting (287 clopidogrel 75 mg, 868 clopidog...

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Veröffentlicht in:	The American journal of cardiology 2014, Vol.113 (1), p.54-59
Hauptverfasser:	Pankert, Mathieu, MD, Quilici, Jacques, MD, Loundou, Anderson Diendonné, PhD, Verdier, Valentine, PhD, Lambert, Marc, MD, Deharo, Pierre, MD, Bonnet, Guillaume, MD, Gaborit, Bénédicte, MD, Morange, Pierre Emmanuel, MD, PhD, Valéro, René, MD, PhD, Dutour, Anne, MD, PhD, Bonnet, Jean-Louis, MD, PhD, Alessi, Marie-Christine, MD, PhD, Cuisset, Thomas, MD, PhD
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Angina pectoris Cardiovascular Cardiovascular disease Cholesterol Coronary Artery Disease - complications Coronary Artery Disease - drug therapy Coronary Artery Disease - surgery Coronary vessels Female Heart attacks Humans Incidence Life Sciences Male Metabolic syndrome Metabolic Syndrome - complications Middle Aged Obesity Obesity - complications Percutaneous Coronary Intervention - methods Piperazines - therapeutic use Platelet Aggregation Inhibitors - therapeutic use Postoperative Hemorrhage - epidemiology Postoperative Hemorrhage - etiology Prasugrel Hydrochloride Purinergic P2Y Receptor Antagonists - therapeutic use Retrospective Studies Stents Thiophenes - therapeutic use Ticlopidine - analogs & derivatives Ticlopidine - therapeutic use United States - epidemiology
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Beschreibung
Zusammenfassung:	This study aimed to analyze the impact of body mass index (BMI) and the metabolic syndrome (MS) on responses to clopidogrel or prasugrel and bleeding risk after acute coronary syndrome. The study included 1,542 consecutive patients who underwent coronary stenting (287 clopidogrel 75 mg, 868 clopidogrel 150 mg, and 387 prasugrel 10 mg). Platelet reactivity was assessed 1 month after discharge using platelet reactivity index vasodilator stimulated phosphoprotein (PRI VASP). Three hundred thirty-six patients (21.8%) were obese (BMI ≥30), and we observed higher platelet reactivity associated with higher BMI across thienopyridine regimens. Incidence of high on-treatment platelet reactivity (PRI VASP >50%) was higher in obese than nonobese patients (p
ISSN:	0002-9149 1879-1913
DOI:	10.1016/j.amjcard.2013.09.011