• Jean-Guillaume Dillinger, Alaa Saeed, Vincent Spagnoli, Sollier Claire Bal Dit CB Department of Angio-hematology and IVS, Lariboisiere Hospital, AP-HP, Paris Diderot University, Paris, France., Georgios Sideris, Silberman Stephane Manzo SM Department of Cardiology, Lariboisiere Hospital, AP-HP, Paris Diderot University - INSERM U 942, Paris, France., Sebastian Voicu, Ludovic Drouet, and Patrick Henry.
• Department of Cardiology, Lariboisiere Hospital, AP-HP, Paris Diderot University - INSERM U 942, Paris, France.
• Thromb. Res. 2016 Aug 1; 144: 56-61.

BackgroundDespite dual antiplatelet treatment, major ischemic events are common following ST elevation myocardial infarction (STEMI). We aimed to assess high platelet reactivity on aspirin (HPR-aspirin) and its association with P2Y12i (HPR-P2Y12i) during the acute phase of STEMI.MethodsWe included all consecutive patients admitted for STEMI treated by primary angioplasty in our center for 1year. All patients received a loading dose followed by a maintenance dose of aspirin (75mg/day) and prasugrel (ticagrelor or clopidogrel if contraindicated). Platelet reactivity was assessed 4±1days and 75±15days after admission using light transmission aggregometry with arachidonic acid (LTA-AA-HPR-aspirin) and VASP (HPR-P2Y12i) to define HPR as well as serum Thromboxane-B2 and LTA-ADP. Major cardiac and cerebrovascular events were recorded for 1year.ResultsWe included 106 patients - mean age was 61y.o., 76% were male and 20% had diabetes. STEMI was anterior in 52% and LV ejection fraction at discharge was 51±9%. 50% of patients were treated with prasugrel and 34% with ticagrelor. At day 4 after STEMI, HPR-aspirin was found in 26% patients and HPR-P2Y12i in 7%. HPR- both aspirin and P2Y12i was found in 4%. Diabetes and age were predictors of HPR-aspirin. HPR-aspirin was persistent 75days later in 36% patients. At 1year, 7.9% patients had experienced major adverse cardiovascular and cerebrovascular events (MACCE). HPR-aspirin and HPR on both aspirin and P2Y12i were significantly associated with MACCE.ConclusionHPR-aspirin is frequent just after STEMI and associated with MACCE especially when associated with HPR-P2Y12i.Copyright © 2016. Published by Elsevier Ltd.

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