The impact of platelet function or C-reactive protein, on cardiovascular events after an acute myocardial infarction
2009 (English)In: Thrombosis Journal, ISSN 1477-9560, Vol. 7, no 12Article in journal (Refereed) Published
Background Recurrent cardiovascular events following acute myocardial infarction (AMI) are common. The purpose of this study was to evaluate the impact of platelet aggregation, PFA-100 closure times and peak C-reactive protein (CRP), respectively, on the occurrence of death, myocardial infarction and ischemic cerebral events after an AMI. Furthermore, to examine the relationship between the platelet function tests and peak CRP.
Methods Three hundred and thirty-four patients with AMI were included in the study. Platelet aggregation was analyzed by an aggregometer using laser light (PA-200). The state of high residual platelet reactivity was defined as normal closure times (PFA-100) during treatment with antiplatelet and antithrombotic drugs.
Results The fourth quartile of peak CRP was associated with poorer outcome as compared to the first quartile in a multivariate Cox-regression analysis, with a hazard ratio of 2.0 (95% CI 1.1-3.7) for the occurrence of death, myocardial infarction and ischemic cerebral events. The fourth quartile of peak CRP (>64.6 mg/l) was associated with platelet aggregation (p < 0.001, adjusted R² = 0.13) and high residual platelet reactivity, in a multivariable model, with an odds ratio of 2.9 (CI 95% 1.3-6.8), as compared to the first quartile. Neither the highest quartile of platelet aggregation nor the state of high residual platelet reactivity predicted new cardiovascular events.
Conclusions In patients with myocardial infarction, measured peak CRP is associated with new cardiovascular events. Despite an association with peak CRP neither more pronounced platelet aggregation nor PFA-100 closure times independently predict new cardiovascular events.
Place, publisher, year, edition, pages
BioMed Central , 2009. Vol. 7, no 12
C-reactive protein, Myocardial infarction, Platelets, Aggregation, PFA-100, Outcome
Cardiac and Cardiovascular Systems
Research subject Medicine
IdentifiersURN: urn:nbn:se:umu:diva-31869DOI: 10.1186/1477-9560-7-12PubMedID: 19583836OAI: oai:DiVA.org:umu-31869DiVA: diva2:297965
ProjectsInflammation, platelet aggregation and prognosis after acute myocardial infarction