Inflammatory state does not affect the antiplatelet efficacy of potent P2Y12 inhibitors in ACS

Benedikt S. Biesinger, Aleksandra Gasecka, Thomas Perkmann, Johann Wojta, Maciej Lesiak, Marek Grygier, Ceren Eyileten, Marek Postuła, Krzysztof J. Filipiak, Aurel Toma, Christian Hengstenberg, Jolanta M. Siller-Matula

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2 Citations (Scopus)

Abstract

Inflammation leads to atherosclerosis and acute coronary syndromes (ACS). We performed a prospective, observational study to assess association between the concentrations of inflammatory markers (high sensitivity C-reactive protein, hsCRP; high sensitivity interleukin6, hsIL-6; soluble CD40 ligand, sCD40 L) and platelet reactivity in 338 patients with ACS treated with ticagrelor and prasugrel. We also assessed whether hsCRP, hsIL-6, and sCD40 L are associated with standard inflammatory markers (white blood cell [WBC] and fibrinogen), and whether they differ according to patient diabetic status and pre-treatment with statins. Concentrations of hsCRP and concentrations of hsIL-6 and sCD40 L were assessed using turbidimetric assay and enzyme-linked immunosorbent assay, respectively. Platelet reactivity was measured using multiple electrode aggregometry. There was only a weak inverse correlation between hsIL-6 and platelet reactivity (r≤-0.125). In contrast, concentration of hsIL6 and hsCRP positively correlated with WBC and fibrinogen (r ≥ 0.199). Insulin-dependent diabetes mellitus (IDDM) was associated with higher concentration of hsIL-6 (p = .014), whereas pre-treatment with statins–with lower concentration of hsIL-6 (p = .035). In conclusion, inflammatory state does not affect the antiplatelet efficacy of potent P2Y12 inhibitors in the acute phase of ACS, confirming the safety and efficacy of potent P2Y12 inhibitors in patients with a high inflammatory burden.

Original languageEnglish
Pages (from-to)498-506
Number of pages9
JournalPlatelets
Volume32
Issue number4
Early online date2020
DOIs
Publication statusPublished - 2021

Keywords

  • Acute Coronary Syndrome
  • inflammation
  • platelet Reactivity
  • prasugrel
  • statin
  • ticagrelor

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