BACKGROUND: Creatinine kinase-MB (CK-MB) and cardiac troponin I (cTnI) elevations are highly specific for myonecrosis after percutaneous coronary intervention (PCI). Aspirin is used to prevent thrombotic complications. Several studies have shown that some individuals exhibit a reduced or completely missing antiplatelet response to aspirin. The aim of this study is to investigate the effects of platelet reactivity despite aspirin therapy on CK-MB and cTnI levels after elective percutaneous coronary interventions despite 600 mg loading dose of clopidogrel. METHODS: One hundred fourteen (mean age 61.2+/-9.3 years, 78.1% male) patients receiving 300 mg daily enteric coated aspirin for at least 7 days with documented coronary artery disease were included in the study. Platelet reactivity despite aspirin was measured by platelet function analyzer (PFA)-100 collagen/epinephrine cartridge. Blood samples for CK-MB and cTnI were obtained before and at 6, 24, and 36 h after the PCI. Persistent platelet reactivity was defined when collagen/epinephrine closure time<165 s. RESULTS: A total of 87 (76.4%) patients were noted to have normal platelet reactivity (Group A), and 27 (23.6%) had persistent platelet reactivity (Group B). The elevations of CK-MB and cTnI levels were statistically significant within the groups (both P<0.001). However, there were no significant differences in the CK-MB and cTnI levels of the groups at baseline and after PCI for all studied hours. CONCLUSION: Persistent platelet reactivity was not associated with increased risk of CK-MB, cTnI elevations in low-to-intermediate risk PCI patients.
BACKGROUND: Creatinine kinase-MB (CK-MB) and cardiac troponin I (cTnI) elevations are highly specific for myonecrosis after percutaneous coronary intervention (PCI). Aspirin is used to prevent thrombotic complications. Several studies have shown that some individuals exhibit a reduced or completely missing antiplatelet response to aspirin. The aim of this study is to investigate the effects of platelet reactivity despite aspirin therapy on CK-MB and cTnI levels after elective percutaneous coronary interventions despite 600 mg loading dose of clopidogrel. METHODS: One hundred fourteen (mean age 61.2+/-9.3 years, 78.1% male) patients receiving 300 mg daily enteric coated aspirin for at least 7 days with documented coronary artery disease were included in the study. Platelet reactivity despite aspirin was measured by platelet function analyzer (PFA)-100 collagen/epinephrine cartridge. Blood samples for CK-MB and cTnI were obtained before and at 6, 24, and 36 h after the PCI. Persistent platelet reactivity was defined when collagen/epinephrine closure time<165 s. RESULTS: A total of 87 (76.4%) patients were noted to have normal platelet reactivity (Group A), and 27 (23.6%) had persistent platelet reactivity (Group B). The elevations of CK-MB and cTnI levels were statistically significant within the groups (both P<0.001). However, there were no significant differences in the CK-MB and cTnI levels of the groups at baseline and after PCI for all studied hours. CONCLUSION: Persistent platelet reactivity was not associated with increased risk of CK-MB, cTnI elevations in low-to-intermediate risk PCI patients.
Authors: R M Califf; A E Abdelmeguid; R E Kuntz; J J Popma; C J Davidson; E A Cohen; N S Kleiman; K W Mahaffey; E J Topol; C J Pepine; R J Lipicky; C B Granger; R A Harrington; B E Tardiff; B S Crenshaw; R P Bauman; B D Zuckerman; B R Chaitman; J A Bittl; E M Ohman Journal: J Am Coll Cardiol Date: 1998-02 Impact factor: 24.094
Authors: P A Gum; K Kottke-Marchant; E D Poggio; H Gurm; P A Welsh; L Brooks; S K Sapp; E J Topol Journal: Am J Cardiol Date: 2001-08-01 Impact factor: 2.778
Authors: John W Eikelboom; Jack Hirsh; Jeffrey I Weitz; Marilyn Johnston; Qilong Yi; Salim Yusuf Journal: Circulation Date: 2002-04-09 Impact factor: 29.690
Authors: Annapoorna S Kini; Paul Lee; Jonathan D Marmur; Ajay Agarwal; Mary E Duffy; Michael C Kim; Samin K Sharma Journal: Am J Cardiol Date: 2004-01-01 Impact factor: 2.778
Authors: Patricia A Gum; Kandice Kottke-Marchant; Patricia A Welsh; Jennifer White; Eric J Topol Journal: J Am Coll Cardiol Date: 2003-03-19 Impact factor: 24.094