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Resistance to thienopyridines: Clinical detection of coronary stent thrombosis by monitoring of vasodilator‐stimulated phosphoprotein phosphorylation
Author(s) -
Barragan Paul,
Bouvier JeanLouis,
Roquebert PierreOlivier,
Macaluso Gilles,
Commeau Philippe,
Comet Bertrand,
Lafont Antoine,
Camoin Laurence,
Walter Ulrich,
Eigenthaler Martin
Publication year - 2003
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.10497
Subject(s) - medicine , thienopyridine , aspirin , clopidogrel , phosphoprotein , platelet , coronary stent , platelet activation , thrombosis , phosphorylation , cardiology , anesthesia , gastroenterology , stent , restenosis , biochemistry , chemistry
We carried out a prospective evaluation of a new vasodilator‐stimulated phosphoprotein (VASP) phosphorylation assay in order to detect patients with high‐risk coronary subacute stent thrombosis (SAT) despite thienopyridine regimen. Twenty healthy donors (group 1) without any medication were compared to 16 stented patients (group 2) treated by ticlopidin or clopidogrel initiated 2 days before stenting and aspirin (250 mg/day). No difference in platelet reactivity was noted between group 1 and group 2 treated only with aspirin (72.00% ± 4.17% vs. 69.73% ± 5.62%, respectively; P = NS). Significant differences were found between patients of group 2 treated with aspirin alone (69.73% ± 5.62%), after 2.0 days (60.14% ± 9.60%; P < 0.05), and after 4.8 ± 1.3 days (48.37% ± 11.19%; P < 0.05) with thienopyridine‐aspirin. Among 1,684 consecutive stented patients, 16 patients who presented an SAT (group 3) were compared with 30 other stented patients free of SAT (group 4). We found a significant difference between group 3 (63.28% ± 9.56%) and group 4 (39.80% ± 10.9%; P < 0.0001). VASP phosphorylation analysis may be useful for the detection of coronary SAT. Cathet Cardiovasc Intervent 2003;59:295–302. © 2003 Wiley‐Liss, Inc.