Title:Relation between the Change in Mean Platelet Volume and Clopidogrel Resistance in Patients Undergoing Percutaneous Coronary Intervention
Volume: 13
Issue: 5
Author(s): Young-Youp Koh, Hyung Ho Kim, Dong-Hyun Choi, Young-Min Lee, Young-Jae Ki, Seong-Ho Kang, Geon Park, Joong-Wha Chung, Kyong-Sig Chang and Soon-Pyo Hong
Affiliation:
Keywords:
Mean platelet volume, clopidogrel resistance, percutaneous coronary intervention.
Abstract: We aimed to determine the association between the change in mean platelet volume (MPV) over time and aspirin/
clopidogrel resistance in patients undergoing percutaneous coronary intervention (PCI). The MPV and platelet function
were analysed in 302 patients who underwent PCI. MPV changes were associated with increased aspirin reaction
units (ARU, r = 0.114; P = 0.047), increased P2Y12 reaction units (PRU, r = 0.193; P = 0.001), and decreased P2Y12%
inhibition (PI%, r = - 0.273; P < 0.001). The group with increasing MPV values showed significantly higher PRU values
and lower PI% compared with the group with decreasing MPV values (222.5 ± 73.9 vs. 195.6 ± 63.7 PRU, P = 0.001;
24.1 ± 21.0 vs. 32.8 ± 18.5 PI%, P < 0.001, respectively). The clopidogrel resistant group (≥235 PRU or ≤15% of PI%)
showed a significantly higher positive change in MPV (ΔMPV) values than the clopidogrel responder group (0.53 ± 0.78
vs. 0.13 ± 0.69 fL, P < 0.001). When the ΔMPV cut-off level was set at 0.20 fL using the receiver operating characteristic
curve, the sensitivity and specificity for differentiating between the clopidogrel resistant and responder groups were
72.6% and 59.3%, respectively. After adjusting for traditional risk factors, the odds ratio in the clopidogrel resistant group
with ΔMPV ≥0.2 fL was 4.10 (95% confidence interval; 1.84-9.17). In conclusion, ΔMPV was associated with PRU and
PI%; a positive ΔMPV was an independent predictive marker for clopidogrel resistance after PCI.
