Frontiers in Cardiovascular Drug Discovery

Volume: 4

Platelet Reactivity in Patients with Coronary Stenting Treated with Dual Antiplatelet Therapy and after Withdrawal of Clopidogrel: Impact of Bioactive Titanium Stent versus Everolimus-coated Stent

Author(s): Amparo Hernandiz, Jose Luis Díez, Antonio Moscardo, Ana Latorre, Maria Dolores Domenech, Maria Teresa Santos and Juana Valles

Pp: 65-82 (18)

DOI: 10.2174/9781681083995119040005

* (Excluding Mailing and Handling)

Abstract

Objective: To study platelet reactivity at different times while on dual antiplatelet therapy (DAPT) with aspirin (ASA) and clopidogrel in patients treated with bioactive stents (TITAN2 ®) or everolimus-coated stents (XIENCE V®) and one month after clopidogrel cessation.

Background: Coronary intervention damages the endothelium and causes platelet response leading to thrombotic occlusion, which is prevented with DAPT.

Methods: We studied 20 patients with bioactive stent and stable ischemia (BAS-SI group); 31 patients with bioactive stent and acute coronary syndrome (BAS-ACS group) and 31 patients with stable ischemia and everolimus-coated stent (EVE group). DAPT was administered (ASA 100 mg/day and clopidogrel 75 mg/day) for one year in BAS-ACS and EVE groups and for 1 month in BAS-SI group. Platelet aggregation induced by different agonists and platelet recruitment were analyzed at different times of DAPT and 1 month after clopidogrel cessation.

Results: After one month of DAPT, platelet aggregation showed no difference between groups; at 12 months of DAPT, the response to collagen and ADP increased in EVE group. Platelet recruitment at 1 month was higher in the BAS-ACS than the other groups; after 12 months, recruitment increased in the EVE group with respect to BASACS. Platelet aggregation and recruitment in diabetics were significantly higher in all situations than in non-diabetic patients. Clopidogrel withdrawal increased ADPinduced aggregation and collagen-induced aggregation and recruitment.

Conclusion: Platelet reactivity in patients with DAPT varies with time, depending on the subset of patients, the type of the stent implanted and the time after implantation.


Keywords: Platelet Activity, Stent, Recruitment, Aggregation, Dual Antiplatelet Therapy, Clopidogrel Withdrawal.

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      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59584110 and j.to_ip >=59584110 )) and ((j.from_date <= 1740496048 and j.to_date >= 1740496048 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12935) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59584110 and j.to_ip >=59584110 )) and ((j.from_date <= 1740496048 and j.to_date >= 1740496048 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12935) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59584110 and j.to_ip >=59584110 )) and ((j.from_date <= 1740496048 and j.to_date >= 1740496048 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12935)
      530μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 2437 and `b`.`banner_from_date` <= 1740496048 and `b`.`banner_to_date` >= 1740496048 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.08msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 2437
      • 3: 1740496048
      • 4: 1740496048
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='a52639ac7d0cde90b5bb59b9d0167dd1'
      220μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    6Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        jqB3oZP8ioBFcFLxAjpKnT7teSGsnhY8e7BO1RD3
        uc_cart_id
        a52639ac7d0cde90b5bb59b9d0167dd1
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/12935" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/12935
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6IkdQNzEzVk5pNER3M1daVWVlUDUzNlE9PSIsInZhbHVlIjoiV3JtZHQ1bUFOMytTeTFZQUd1Z1pwaXpuSDRCa2VvcHRoekgvVTJkUzh5Zz0iLCJtYWMiOiJmZjY0NzNhMjVhMzBhYTY3ZGEwNTc3YTc3ZDFlMjYzM2NjYTljMThkMTdjNWZjNzA4NjcyMDQ2M2FjNmQ3Njk0IiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6IkdQNzEzVk5pNER3M1daVWVlUDUzNlE9PSIsInZhbHVlIjoiV3JtZHQ1bUFOMytTeTFZQUd1Z1pwaXpuSDRCa2VvcHRoekgvVTJkUzh5Zz0iLCJtYWMiOiJmZjY0NzNhMjVhMzBh" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Tue, 25 Feb 2025 15:07:28 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkdBVjhHWlUwd1ZYbE5DQTlwZXdyVWc9PSIsInZhbHVlIjoiaU84NCsyeC9iYjY5a2VVOFloUVhyeVBLZmJMb0Ztc0FCQm5OWllwdE5oTmtOdGxTMTBOSWlLeUpOWlhuQlphZXlSMzkvUXdWSnIwMW80SWJZQ0FzWWdrazMwWlBUckJzYjErVU53YnlNVjlvc1BqRDVXN1ltZW9GbTljRnNMZUgiLCJtYWMiOiI3OWMwYzI0ZDU1YjE3MWMyODAzYzIzNjgzY2JiZjVmNzgwMjc4YmEwY2E2OTUwMTkzYTIwYWVjMTA2OTNjZTI2IiwidGFnIjoiIn0%3D; expires=Fri, 28 Feb 2025 03:07:28 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IkdBVjhHWlUwd1ZYbE5DQTlwZXdyVWc9PSIsInZhbHVlIjoiaU84NCsyeC9iYjY5a2VVOFloUVhyeVBLZmJMb0Ztc0FCQm5OWllwdE5oTmtOdGxTMTBOSWlLeUpOWlhuQlphZXlSMzkvU" 1 => "alphaeurekaselectnet_session=eyJpdiI6Im5qQmllVnVnMnZQampTekt3ZmRzZUE9PSIsInZhbHVlIjoiNThIdHhYRWdvSElNZUsyZFdHQ0NPK0RGa0J3cmJvb0FlaG1FT2FjVGJ4c1dZUCtBT2VhNS9NQkdpamRGb2t3YnJxK2tvbExQckNDdm1iTDJPdk5SLzJ0UTkza1hQc3ZxeVdxSGQ1M3YwTHBNQWpxQXNLRTU4VnZhMmR4T0tmclkiLCJtYWMiOiI2MWIzZmFkNzRkNzU5YTYwMjJjNDAyMTNjOWVmZjI1ZTBjN2FhYzM1Y2YyOWVkOTdiZTFlOGEzMDJiMWUyZmY4IiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6Im5qQmllVnVnMnZQampTekt3ZmRzZUE9PSIsInZhbHVlIjoiNThIdHhYRWdvSElNZUsyZFdHQ0NPK0RGa0J3cmJvb0FlaG1FT2FjVGJ4c1dZUCtBT2VhNS9NQkd" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkdBVjhHWlUwd1ZYbE5DQTlwZXdyVWc9PSIsInZhbHVlIjoiaU84NCsyeC9iYjY5a2VVOFloUVhyeVBLZmJMb0Ztc0FCQm5OWllwdE5oTmtOdGxTMTBOSWlLeUpOWlhuQlphZXlSMzkvUXdWSnIwMW80SWJZQ0FzWWdrazMwWlBUckJzYjErVU53YnlNVjlvc1BqRDVXN1ltZW9GbTljRnNMZUgiLCJtYWMiOiI3OWMwYzI0ZDU1YjE3MWMyODAzYzIzNjgzY2JiZjVmNzgwMjc4YmEwY2E2OTUwMTkzYTIwYWVjMTA2OTNjZTI2IiwidGFnIjoiIn0%3D; expires=Fri, 28-Feb-2025 03:07:28 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IkdBVjhHWlUwd1ZYbE5DQTlwZXdyVWc9PSIsInZhbHVlIjoiaU84NCsyeC9iYjY5a2VVOFloUVhyeVBLZmJMb0Ztc0FCQm5OWllwdE5oTmtOdGxTMTBOSWlLeUpOWlhuQlphZXlSMzkvU" 1 => "alphaeurekaselectnet_session=eyJpdiI6Im5qQmllVnVnMnZQampTekt3ZmRzZUE9PSIsInZhbHVlIjoiNThIdHhYRWdvSElNZUsyZFdHQ0NPK0RGa0J3cmJvb0FlaG1FT2FjVGJ4c1dZUCtBT2VhNS9NQkdpamRGb2t3YnJxK2tvbExQckNDdm1iTDJPdk5SLzJ0UTkza1hQc3ZxeVdxSGQ1M3YwTHBNQWpxQXNLRTU4VnZhMmR4T0tmclkiLCJtYWMiOiI2MWIzZmFkNzRkNzU5YTYwMjJjNDAyMTNjOWVmZjI1ZTBjN2FhYzM1Y2YyOWVkOTdiZTFlOGEzMDJiMWUyZmY4IiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6Im5qQmllVnVnMnZQampTekt3ZmRzZUE9PSIsInZhbHVlIjoiNThIdHhYRWdvSElNZUsyZFdHQ0NPK0RGa0J3cmJvb0FlaG1FT2FjVGJ4c1dZUCtBT2VhNS9NQkd" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "jqB3oZP8ioBFcFLxAjpKnT7teSGsnhY8e7BO1RD3" "uc_cart_id" => "a52639ac7d0cde90b5bb59b9d0167dd1" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/12935" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-25 15:07:28GET/chapter/12935112198