From the PENDULUM registry, high platelet response (HPR) was significantly associated with risk of thrombotic/ischemic events in patients at high bleeding risk (HBR) undergoing PCI, as reported by Dr. Raisuke Iijima of Toho University Ohashi Medical Center and his colleagues in the May issue of Circulation Journal.
High Platelet Response and Ischemic and Bleeding Events in Patients Undergoing PCI with HBR: The PENDULUM Registry
In a post-hoc analysis of the PENDULUM registry, which enrolled patients undergoing PCI, Dr. Iijima et al. classified the patients into HBR and non-HBR, stratified by perioperative HPR (PRU>208) or non-HPR (PRU≤208), and evaluated for 12-month cardiovascular and cerebrovascular events as well as bleeding events.
The rate of ischemic and bleeding events was about 3 times higher in HBR patients than in non-HBR patients. Thrombotic/ischemic events were more common in the HPR subgroup in HBR patients (HR 1.59 [95%CI 1.11-2.28] p=0.012), but this difference was not present in non-HBR patients. After adjusting for covariates, HPR in HBR patients was an independent predictor of thrombotic/ischemic events (HR 1.69 [95%CI 1.13-2.54] p=0.011).
Dr. Iijima et al. summarized, “HBR patients had a 2.8-fold risk of thrombotic/ischemic events and a 3-fold risk of BARC 3 or 5 bleeding events compared with non-HBR patients, and HPR significantly increased the risk of thrombotic/ischemic events in HBR patients, indicating that adequate control of platelet response levels during PCI, especially in HBR patients, is important for improved clinical outcomes.”
Iijima R, et al. Circ J. 2022; 86: 763-771
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