For a study, the researchers sought to determine the effect of low platelet reactivity (LPR) in determining the bleeding risk of patients who had percutaneous coronary intervention (PCI) based on their diabetes status. A total of 472 individuals were retrospectively included who had PCI with aspirin and clopidogrel. The VerifyNow P2Y(12) assay was used to determine platelet reactivity. Platelet reactivity unit 178 was used to define LPR. The primary outcome was the occurrence of any bleeding during 5 years, stratified by diabetic Mellitus (DM) status and LPR. In 30.5% of patients, diabetes was found. LPR was shown to be less common in diabetic patients (p=0.077). After 5 years, 11.9% of patients had a bleeding problem. The incidence of bleeding did not differ between those who had DM and those who did not (p=0.24). In patients with and without diabetes, LPR exhibited a similar value for stratifying the higher bleeding risk (interaction p between DM and LPR 0.69). Patients with and without LPR and DM had a stepwise increase in the crude rates of bleeding complications (log-rank p=0.004), with those affected by both conditions having the greatest crude incidence rate. Finally, around 1/3 of patients who underwent PCI on clopidogrel have LPR in addition to aspirin. Regardless of DM status, LPR assessment greatly adds value for predicting bleeding. Although the presence of DM does not enhance the risk of hemorrhagic complications in and of itself, the presence of DM plus LPR identifies the subgroup with the highest risk of bleeding.
Source:www.ajconline.org/article/S0002-9149(22)00124-2/fulltext
