Platelet function, coagulation and fibrinolysis in patients with previous coronary and cerebrovascular ischemic events

Imagem de Miniatura
Arquivos
art_BARBOSA_Platelet_function_coagulation_and_fibrinolysis_in_patients_with_2019.PDF (479.64 KB)
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2019
DOI
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
HOSPITAL CLINICAS, UNIV SAO PAULO
Autores
BARREIROS, Renata de Souza
ARANTES, Flavia Bittar Brito
Citação
CLINICS, v.74, article ID e1222, 6p, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
OBJECTIVES: Ischemic stroke (IS) or transient ischemic attack (TIA) history is present in 4-17% of patients with coronary artery disease (CAD). This subgroup of patients is at high risk for both ischemic and bleeding events. The aim of this study was to determine the role of platelet aggregability, coagulation and endogenous fibrinolysis in patients with CAD and previous IS or TIA. METHODS: A prospective case-control study that included 140 stable CAD patients divided into two groups: the CASE group (those with a previous IS/TIA, n=70) and the CONTROL group (those without a previous IS/TIA, n=70). Platelet aggregability (VerifyNow Aspirin (R) and VerifyNow P2Y12 (R)), coagulation (fibrinogen and thromboelastography by Reorox (R)) and endogenous fibrinolysis (D dimer and plasminogen activator inhibitor-1) were evaluated. RESULTS: Patients in the CASE group presented significantly higher systolic blood pressure levels (135.84 +/- 16.09 vs 123.68 +/- 16.11, p <0.01), significantly more previous CABG (25.71% vs 10%, p=0.015) and significantly higher calcium channel blocker usage (42.86% vs 24.29%, p=0.02) than those in the control group. In the adjusted models, low triglyceride values, low hemoglobin values and higher systolic blood pressure were significantly associated with previous IS/TIA (CASE group). Most importantly, platelet aggregability, coagulation and fibrinolysis tests were not independently associated with previous cerebrovascular ischemic events (CASE group). CONCLUSION: Platelet aggregability, coagulation and endogenous fibrinolysis showed similar results among CAD patients with and without previous IS/TIA. Therefore, it remains necessary to identify other targets to explain the higher bleeding risk presented by these patients.
Palavras-chave
Platelet Aggregation, Blood Coagulation, Fibrinolysis, Coronary Disease, Stroke
URI
https://observatorio.fm.usp.br/handle/OPI/33970
Referências
  1. Alfredsson J, 2017, HEART, V103, P1168, DOI 10.1136/heartjnl-2016-310090
  2. Alvarez-Sabin J, 2013, LANCET NEUROL, V12, P689, DOI 10.1016/S1474-4422(13)70055-3
  3. Bassand JP, 2010, EUR HEART J, V31, P50, DOI 10.1093/eurheartj/ehp401
  4. Boersma E, 2000, CIRCULATION, V101, P2557, DOI 10.1161/01.CIR.101.22.2557
  5. Bonaventure A, 2010, ATHEROSCLEROSIS, V210, P243, DOI 10.1016/j.atherosclerosis.2009.10.043
  6. Breet NJ, 2011, NETH HEART J, V19, P279, DOI 10.1007/s12471-011-0105-5
  7. BRUCKDORFER KR, 1969, BIOCHIM BIOPHYS ACTA, V183, P334, DOI 10.1016/0005-2736(69)90089-3
  8. Campo G, 2013, THROMB RES, V132, P151, DOI 10.1016/j.thromres.2013.06.007
  9. Chen WH, 2004, J AM COLL CARDIOL, V43, P1122, DOI 10.1016/j.jacc.2003.12.034
  10. Chen WH, 1998, STROKE, V29, P631, DOI 10.1161/01.STR.29.3.631
  11. Diener HC, 2004, LANCET, V364, P331, DOI 10.1016/S0140-6736(04)16721-4
  12. Ducrocq G, 2013, CIRCULATION, V127, P730, DOI 10.1161/CIRCULATIONAHA.112.141572
  13. Eugster M, 2005, THROMB HAEMOSTASIS, V94, P1213, DOI 10.1160/TH05-06-0424
  14. Gage BF, 2001, JAMA-J AM MED ASSOC, V285, P2864, DOI 10.1001/jama.285.22.2864
  15. Goodman SG, 2017, INT J CARDIOL, V236, P54, DOI 10.1016/j.ijcard.2017.02.062
  16. Granger CB, 2003, ARCH INTERN MED, V163, P2345, DOI 10.1001/archinte.163.19.2345
  17. Machida T, 2010, J INT MED RES, V38, P1975, DOI 10.1177/147323001003800611
  18. Mathews R, 2011, AM J CARDIOL, V107, P1136, DOI 10.1016/j.amjcard.2010.12.009
  19. Mehran R, 2010, J AM COLL CARDIOL, V55, P2556, DOI 10.1016/j.jacc.2009.09.076
  20. Morrow DA, 2012, NEW ENGL J MED, V366, P1404, DOI 10.1056/NEJMoa1200933
  21. Mukherjee D, 2007, AM J CARDIOL, V100, P1, DOI 10.1016/j.amjcard.2007.02.046
  22. Okafor ON, 2015, J AM COLL CARDIOL, V65, P1683, DOI 10.1016/j.jacc.2015.02.040
  23. Pezzini A, 2008, NEUROL SCI, V29, pS260, DOI 10.1007/s10072-008-0957-7
  24. Pisters R, 2010, CHEST, V138, P1093, DOI 10.1378/chest.10-0134
  25. REED DM, 1990, AM J EPIDEMIOL, V131, P579, DOI 10.1093/oxfordjournals.aje.a115542
  26. REIMERS RC, 1984, BLOOD, V64, P1200
  27. Smith EE, 2002, NEUROLOGY, V59, P193, DOI 10.1212/WNL.59.2.193
  28. Stone GW, 2013, LANCET, V382, P614, DOI 10.1016/S0140-6736(13)61170-8
  29. Subherwal S, 2009, CIRCULATION, V119, P1873, DOI 10.1161/CIRCULATIONAHA.108.828541
  30. TURITTO VT, 1980, SCIENCE, V207, P541, DOI 10.1126/science.7352265
  31. Wieberdink RG, 2011, ARTERIOSCL THROM VAS, V31, P2982, DOI 10.1161/ATVBAHA.111.234948
  32. Wiviott SD, 2007, NEW ENGL J MED, V357, P2001, DOI 10.1056/NEJMoa0706482
  33. Zeymer U, 2015, HERZ, V40, P27, DOI 10.1007/s00059-014-4161-7

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - ODS/03