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Clinical TrialVolume 71, Issue 11 Supplement, March 2018

JOURNAL：J Am Coll Cardiol. Article Link

Comparison Of High Shear Stress-Induced Thrombotic And Thrombolytic Effect Between Aspirin, Clopidogrel And Very Low Dose Rivaroxaban And Aspirin, Ticagrelor Treatments In Patients With Acute Coronary Syndrome

M Kim, KS Hyuk, JJ Park et al. Keywords: high shear stress; global thrombosis test;

ABSTRACT

BACKGROUND - Global thrombosis test (GTT) is a simple but useful method to measure high shear stress-induced whole blood thrombotic and endogenous thrombolytic activity and it may mimic platelet aggregation in acute coronary syndrome (ACS) condition more accurately compared to conventional platelet function tests. We compared GTT and conventional platelet function test (VerifyNow® test) in patients with ACS who were treated aspirin/ticagrelor (TICA) or aspirin/clopidogrel/very low dose rivaroxaban (RIVA).


METHODS - A total of 41 patients (TICA (n=24), RIVA (n=17)) who underwent percutaneous coronary intervention were consecutively enrolled. GTT and VerifyNow®test were performed at day 2 (D2) and day 30 (D30) after successful PCI. We compared occlusion time (OT), lysis time (LT), aspirin reaction unit (ARU) and P2Y12 reaction unit (PRU) between the two groups at D2 and D30.


RESULTS - There were no significant statistical differences in baseline clinical, angiographic and laboratory characteristics between the two groups. At D2, there were no significant differences in OT (483.5±94.4 sec vs. 540.1±146.2 sec, p=0.239), LT (1,952.2±1,420.9 sec vs. 1,919.2±1,125.4 sec, p=0.253) or ARU (490.0±79.3 vs. 455.9±73.3, p=0.102), but PRU was significantly lower in the TICA group (34.8±60.1 vs. 130.9±70.6, p<0.001). At D30, there were no significant differences in OT (553.5±111.1 sec vs. 634.2±152.0 sec, p=0.121), LT (1540.7±704.1 sec vs. 1679.2±529.4 sec, p=0.261) or ARU (441.4±83.9 vs. 468.8±69.7, p=0.144) between two groups, and PRU was consistently lower in the TICA group (34.6±36.1 vs. 164.8±70.6, p<0.001).


CONCLUSION - High shear stress-induced global thrombotic and lytic activity did not differ between the two antithrombotic regimens although TICA showed more potent inhibition of ADP-induced platelet aggregation.



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