PMID- 23677380
OWN - NLM
STAT- MEDLINE
DCOM- 20140307
LR  - 20181203
IS  - 2567-689X (Electronic)
IS  - 0340-6245 (Linking)
VI  - 110
IP  - 1
DP  - 2013 Jul
TI  - Combined and independent impact of diabetes mellitus and chronic kidney disease 
      on residual platelet reactivity.
PG  - 118-23
LID - 10.1160/TH13-01-0004 [doi]
AB  - Patients with both chronic kidney disease (CKD) and diabetes mellitus (DM) are at 
      increased risk for thrombotic events compared to those with one abnormality 
      alone. Whether this can be attributed to changes in platelet reactivity among 
      those with both CKD and DM is unknown. We prospectively studied 438 
      clopidogrel-naive patients undergoing percutaneous coronary intervention (PCI). 
      Platelet function tests were performed 4-6 hours after loading with 600 mg of 
      clopidogrel. Platelet reactivity was assessed using the VerifyNow system and 
      expressed as P2Y12 reaction units (PRU). High residual platelet reactivity (HRPR) 
      was defined as PRU > 230. Patients were categorised into four groups by the 
      presence or absence of CKD and DM. Among those without CKD or DM (n=166), DM 
      alone (n=150), CKD alone (n=60) and both CKD and DM (n=62) the mean PRU levels 
      were 201.6 +/- 96.3, 220.5 +/- 101.1, 254.9 +/- 106.7 and 275.0 +/- 94.5, respectively 
      (p<0.001). Analogously, the prevalence of HRPR was 42.3%, 50.7%, 63.3% and 75.8%, 
      respectively (p< 0.001). Associations between either CKD or DM alone and HRPR 
      were attenuated after multivariable adjustment while the odds for HRPR associated 
      with both CKD and DM remained significant (OR [95% CI]: 2.61 [1.16 - 5.86]). In 
      conclusion, the presence of both CKD and DM confers a synergistic impact on 
      residual platelet reactivity when compared to either condition alone. Whether 
      more potent platelet inhibitors may improve outcomes among patients with both 
      abnormalities warrants investigation.
FAU - Baber, Usman
AU  - Baber U
AD  - Cardiac Catheterization Laboratory, Mount Sinai Medical Center, One Gustave L. 
      Levy Place, New York, NY 10029, USA. samin.sharma@mountsinai.org
FAU - Bander, Jeffrey
AU  - Bander J
FAU - Karajgikar, Rucha
AU  - Karajgikar R
FAU - Yadav, Kapil
AU  - Yadav K
FAU - Hadi, Ali
AU  - Hadi A
FAU - Theodoropolous, Kleanthis
AU  - Theodoropolous K
FAU - Gukathasan, Nilusha
AU  - Gukathasan N
FAU - Roy, Swathi
AU  - Roy S
FAU - Sayeneni, Swapna
AU  - Sayeneni S
FAU - Scott, Stuart A
AU  - Scott SA
FAU - Kovacic, Jason C
AU  - Kovacic JC
FAU - Yu, Jennifer
AU  - Yu J
FAU - Sartori, Samantha
AU  - Sartori S
FAU - Mehran, Roxana
AU  - Mehran R
FAU - Uribarri, Jaime
AU  - Uribarri J
FAU - Badimon, Juan J
AU  - Badimon JJ
FAU - Muntner, Paul
AU  - Muntner P
FAU - Moreno, Pedro
AU  - Moreno P
FAU - Kini, Annapoorna S
AU  - Kini AS
FAU - Sharma, Samin K
AU  - Sharma SK
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130516
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (P2RY12 protein, human)
RN  - 0 (Receptors, Purinergic P2Y12)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
MH  - Aged
MH  - Clopidogrel
MH  - Diabetes Complications/*blood
MH  - Diabetes Mellitus/*blood
MH  - Female
MH  - Humans
MH  - Kidney Diseases/*blood
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention
MH  - Platelet Activation
MH  - Platelet Function Tests
MH  - Preoperative Care
MH  - Prospective Studies
MH  - Receptors, Purinergic P2Y12/metabolism
MH  - Risk
MH  - Thrombosis
MH  - Ticlopidine/administration & dosage/analogs & derivatives
MH  - Treatment Outcome
EDAT- 2013/05/17 06:00
MHDA- 2014/03/08 06:00
CRDT- 2013/05/17 06:00
PHST- 2013/01/03 00:00 [received]
PHST- 2013/04/20 00:00 [accepted]
PHST- 2013/05/17 06:00 [entrez]
PHST- 2013/05/17 06:00 [pubmed]
PHST- 2014/03/08 06:00 [medline]
AID - 13-01-0004 [pii]
AID - 10.1160/TH13-01-0004 [doi]
PST - ppublish
SO  - Thromb Haemost. 2013 Jul;110(1):118-23. doi: 10.1160/TH13-01-0004. Epub 2013 May 
      16.