Clin Res Cardiol 98, Suppl 1, April 2009

V1615 - Increased residual platelet function is associated with a reduced glomerular filtration rate in patients undergoing coronary intervention
P. Htun1, T. Geisler1, C. Bischofs1, B. Bigalke1, K. Stellos1, A. May1, C. Herdeg1, M. Gawaz1
1Medizinische Klinik und Poliklinik III / Kardiologie, Medizinische Universitätsklinik Tübingen, Tübingen;
Introduction: Patients with chronic kidney disease are at higher risk for coronary artery disease (CAD) and also their postinterventional outcome is worse compared to patients without renal disease. Aim of this study was to detect a correlation of platelet aggregation and renal function in a standard dual antiplatelet therapy (Clopidogrel and Aspirin).
Study design: Patients admitted to our clinic for cardiovascular intervention with a symptomatic CAD were routinely evaluated by platelet function analysis in this monocenter registry. For the present analysis we retrospectively evaluated a consecutive cohort of 1576 patients with stable and unstable CAD undergoing PCI.
Serum creatinine was obtained during hospital stay and the renal function (glomerular filtration rate) was determined according MDRD.
Platelet aggregation: Patient blood was collected at least 6 h after administration of a loading dose of 600 mg clopidogrel and 75 mg maintaince dose, when maximum platelet  inhibition was achieved. Blood  samples were collected in 3.8% citrate plasma. Platelet aggregation was  stimulated with 20┬Ámol/L adenosine diphospate (ADP) and was assessed by light aggregometry. Late aggregation was used to describe residual platelet activity.
Results: A correlation could be detected between the ADP induced residual aggregation and the GFR
(r: -0.13; p<0.001, n = 1576).


Conclusion: In this study a correlation between an increased residual platelet aggregation and the minimal GFR was shown. Thus, patients with renal impairment may be at increased risk for stentthrombosis after coronary stenting treated by conventional doses of dual antiplatelet therapy.