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Impact of the Degree of Peri-Interventional Platelet Inhibition After Loading With Clopidogrel on Early Clinical Outcome of Elective Coronary Stent Placement

Willibald Hochholzer, MD^_*, Dietmar Trenk, PhD^_*, Hans-Peter Bestehorn, MD^_*, Benjamin Fischer^_*, Christian M. Valina, MD^_*, Miroslaw Ferenc, MD^_*, Michael Gick, MD^_*, Angelika Caputo, PhD, Heinz Joachim Büttner, MD^_* and Franz-Josef Neumann, MD^_*,_*

^_* Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany
Institut für Medizinische Biometrie und Medizinische Informatik, University of Freiburg, Freiburg, Germany.

View larger version (31K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Trial profile. ASA = aspirin; PCI = percutaneous coronary intervention.

View larger version (38K): [in this window] [in a new window] [Download PPT slide]   Figure 2 Cumulative incidence of major adverse cardiac events (MACE) within 30 days after percutaneous coronary intervention (PCI) by quartiles of adenosine diphosphate-induced platelet aggregation. p value determined by log-rank test.

View larger version (25K): [in this window] [in a new window] [Download PPT slide]   Figure 3 Odds ratios for 30-day major adverse cardiac events (MACE) and 95% confidence intervals in various logistic regression models with adenosine diphosphate (ADP)-induced platelet aggregation above median (A) or absolute ADP-induced platelet aggregation (B) at the time of percutaneous coronary intervention (PCI) as independent variable. *Demographic, clinical, and angiographic variables of Table 1 with a difference between quartiles of aggregation at p 0.20. Demographic, clinical, and angiographic variables of Table 4 .

View larger version (24K): [in this window] [in a new window] [Download PPT slide]   Figure 4 Percentage of patients with aggregation above median stratified according to various clusters of time after clopidogrel loading. Error bars represent 95% confidence intervals. Number of patients within the cluster and percentage of the entire cohort are given below the columns. The p values for comparison between clusters of time were determined by chi-square test. ADP = adenosine diphosphate; PCI = percutaneous coronary intervention.