Impact of renin angiotensin system inhibitors on homocysteine levels and platelets reactivity in patients on dual antiplatelet therapy.

血小板活化 内分泌学
作者
Matteo Nardin,Monica Verdoia,Rocco Gioscia,Federica Negro,Giuseppe De Luca
出处
期刊:Nutrition Metabolism and Cardiovascular Diseases [Elsevier]
卷期号:31 (4): 1276-1285 被引量:1
标识
DOI:10.1016/j.numecd.2020.12.004
摘要

Abstract Background and aims Dual antiplatelet therapy (DAPT) and Renin-angiotensin system inhibitors (RASi) represent the cornerstone in the treatment of patients undergoing percutaneous coronary interventions (PCI), mainly after an acute ischemic event. However, high-on treatment residual platelet reactivity (HRPR), is not infrequent despite optimal medical treatment. Homocysteine (Hcy) is a metabolite of methionine catabolism linked to atherothrombosis. Recently, a potential crosstalk between RAS and Hcy has been suggested, potentially favouring platelet aggregation and cardiovascular disease.Therefore, we aimed to investigate the impact of RASi on Hcy levels and platelet aggregation in patients on DAPT after PCI. Methods and results Patients undergoing PCI on DAPT with ASA plus an ADP-antagonist (clopidogrel, ticagrelor or prasugrel), were included. RASi comprised angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB). Aggregation tests were performed by Multiple Electrode Aggregometry. We included 1210 patients, of whom 862 (71.2%) were on treatment with RASi. Overall, DAPT composition was ASA+clopidogrel in 566 (46.8%) patients, ASA+ticagrelor in 428 (35.4%) and ASA+prasugrel in 216 (17.9%). Median values of Hcy were higher in RASi patients (p = 0.006), who displayed a higher percentage of Hcy above the median value (52.4% vs. 44.8%, p = 0.019, adjustedOR [95%CI] = 1.40 [1.04–1.88], p = 0.027). No differences in HRPR rate were found according to RASi use for ASPI test (3.6% vs. 3.3%, p = 0.88) and ADP test (25.6% vs. 24.3%,p = 0.62; adjustedOR [95%CI] = 1.23 [0.89–1.70], p = 0.220) and according to ADP-antagonist type. A direct linear relationship was observed between platelet reactivity and Hcy in both patients receiving RASi and untreated ones, with higher values of platelet aggregation being observed in patients with Hcy above the median, independently from RASi administration and DAPT strategy. Conclusion In patients on DAPT after PCI, RASi treatment did not emerge as an independent predictor of HRPR. However, the levels of Hcy were significantly elevated in patients on RASi and related to higher values of platelet reactivity, independently from the DAPT strategy.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
Lucas应助章鱼小丸子采纳,获得30
1秒前
领导范儿应助努力的欢欢采纳,获得10
1秒前
1秒前
16发布了新的文献求助10
2秒前
2秒前
3秒前
phoebe发布了新的文献求助30
3秒前
3秒前
冷傲的如柏完成签到,获得积分10
3秒前
孔难破完成签到,获得积分10
3秒前
8Qq1NV发布了新的文献求助10
4秒前
4秒前
5秒前
斯文败类应助咕咕采纳,获得10
5秒前
思源应助一碗小米饭采纳,获得10
5秒前
开放的白晴应助dopamine采纳,获得10
6秒前
jinju发布了新的文献求助10
6秒前
星辰大海应助meimale采纳,获得10
6秒前
vee完成签到,获得积分10
6秒前
大模型应助czb666采纳,获得10
6秒前
wanci应助Sigyn采纳,获得10
6秒前
6秒前
6秒前
西南风完成签到,获得积分10
7秒前
脑洞疼应助刘芸芸采纳,获得10
7秒前
钱俊发布了新的文献求助10
8秒前
斯文败类应助某人金采纳,获得10
8秒前
Healer发布了新的文献求助10
8秒前
8秒前
wao完成签到 ,获得积分10
9秒前
9秒前
吾儿坤完成签到,获得积分10
9秒前
在水一方应助鳗鱼不尤采纳,获得10
10秒前
Vicky完成签到 ,获得积分10
10秒前
离子电池完成签到,获得积分10
11秒前
YangSY发布了新的文献求助10
11秒前
11秒前
xlx应助冬青采纳,获得10
11秒前
11秒前
高分求助中
Production Logging: Theoretical and Interpretive Elements 2700
Mechanistic Modeling of Gas-Liquid Two-Phase Flow in Pipes 2500
Kelsen’s Legacy: Legal Normativity, International Law and Democracy 1000
Handbook on Inequality and Social Capital 800
Conference Record, IAS Annual Meeting 1977 610
Interest Rate Modeling. Volume 3: Products and Risk Management 600
Interest Rate Modeling. Volume 2: Term Structure Models 600
热门求助领域 (近24小时)
化学 材料科学 生物 医学 工程类 有机化学 生物化学 物理 纳米技术 计算机科学 内科学 化学工程 复合材料 基因 遗传学 物理化学 催化作用 量子力学 光电子学 冶金
热门帖子
关注 科研通微信公众号,转发送积分 3546888
求助须知:如何正确求助?哪些是违规求助? 3123917
关于积分的说明 9357332
捐赠科研通 2822504
什么是DOI,文献DOI怎么找? 1551513
邀请新用户注册赠送积分活动 723546
科研通“疑难数据库(出版商)”最低求助积分说明 713791