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- Open Access
Impact of P2Y12-mediated platelet reactivity on myocardial perfusion of patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a cardiac magnetic resonance study
© La Manna et al; licensee BioMed Central Ltd. 2015
- Published: 3 February 2015
- Myocardial Perfusion
- Infarct Size
- Cardiac Magnetic Resonance
- P2Y12 Receptor
Whether high platelet reactivity (HPR) at the time of angiography is associated with worse myocardial reperfusion after primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) is unknown. This study aimed to assess the impact of HPR on infarct size and reperfusion injury determined by cardiac magnetic resonance (CMR) in patients with STEMI undergoing PPCI.
Patients with STEMI undergoing PPCI and pretreated with a P2Y12-receptor antagonist (clopidogrel, prasugrel or ticagrelor) underwent platelet function testing at the time of angiography and a CMR from 7 to 10 days after the index event. Platelet function testing was performed with the VerifyNow assay. HPR was defined according to expert consensus definitions. Central core laboratory-masked analyses for quantified ventricular function, volumes, infarct size, area at risk (edema), microvascular obstruction, intramyocardial hemorrhage were performed. These latter parameters were compared between HPR and non-HPR patients.
In patients with STEMI undergoing PPCI pretreated with a P2Y12 receptor antagonist, the presence of HPR at the time of angiography was associated with higher area at risk and infarct size. These findings suggest the need for achieving at earliest as possible an effective P2Y12-inhibition.
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