Point-of-care measured platelet inhibition correlates with a reduced risk of an adverse cardiac event after percutaneous coronary intervention: Results of the GOLD (AU-assessing ultegra) multicenter study

Steven R. Steinhubl, J. David Talley, Gregory A. Braden, James E. Tcheng, Peter J. Casterella, David J. Moliterno, Frank I. Navetta, Peter B. Berger, Jeffrey J. Popma, George Dangas, Richard Gallo, David C. Sane, Jorge F. Saucedo, Gang Jia, A. Michael Lincoff, Pierre Theroux, David R. Holmes, Paul S. Teirstein, Dean J. Kereiakes

Research output: Contribution to journalArticle

328 Scopus citations

Abstract

Background - The optimal level of platelet inhibition with a glycoprotein (GP) IIb/IIIa antagonist necessary to minimize thrombotic complications in patients undergoing a percutaneous coronary intervention (PCI) is currently unknown. Methods and Results - Five hundred patients undergoing a PCI with the planned use of a GP IIb/IIIa inhibitor had platelet inhibition measured at 10 minutes, 1 hour, 8 hours, and 24 hours after the initiation of therapy with the Ultegra Rapid Platelet Function Assay (Accumetrics). Major adverse cardiac events (MACEs: composite of death, myocardial infarction, and urgent target vessel revascularization) were prospectively monitored, and the incidence correlated with the measured level of platelet function inhibition at all time points. One quarter of all patients did not achieve ≥95% inhibition 10 minutes after the bolus and experienced a significantly higher incidence of MACEs (14.4% versus 6.4%, P=0.006). Patients whose platelet function was <70% inhibited at 8 hours after the start of therapy had a MACE rate of 25% versus 8.1% for those ≥70% inhibited (P=0.009). By multivariate analysis, platelet function inhibition ≥95% at 10 minutes after the start of therapy was associated with a significant decrease in the incidence of a MACE (odds ratio 0.46, 95% CI 0.22 to 0.96, P=0.04). Conclusions - Substantial variability in the level of platelet function inhibition is achieved with GP IIb/IIIa antagonist therapy among patients undergoing PCI. The level of platelet function inhibition as measured by a point-of-care assay is an independent predictor for the risk of MACEs after PCI.

Original languageEnglish (US)
Pages (from-to)2572-2578
Number of pages7
JournalCirculation
Volume103
Issue number21
DOIs
StatePublished - May 29 2001

Keywords

  • Angioplasty
  • Complications
  • Platelets

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Point-of-care measured platelet inhibition correlates with a reduced risk of an adverse cardiac event after percutaneous coronary intervention: Results of the GOLD (AU-assessing ultegra) multicenter study'. Together they form a unique fingerprint.

  • Cite this

    Steinhubl, S. R., Talley, J. D., Braden, G. A., Tcheng, J. E., Casterella, P. J., Moliterno, D. J., Navetta, F. I., Berger, P. B., Popma, J. J., Dangas, G., Gallo, R., Sane, D. C., Saucedo, J. F., Jia, G., Lincoff, A. M., Theroux, P., Holmes, D. R., Teirstein, P. S., & Kereiakes, D. J. (2001). Point-of-care measured platelet inhibition correlates with a reduced risk of an adverse cardiac event after percutaneous coronary intervention: Results of the GOLD (AU-assessing ultegra) multicenter study. Circulation, 103(21), 2572-2578. https://doi.org/10.1161/01.CIR.103.21.2572