Background: The association of platelet reactivity and clinical outcomes, especially stent thrombosis, was not so\nclear. We sought to investigate whether high platelet reactivity affects clinical outcomes of patients with drug\neluting stents (DESs) implantation.\nMethods: All enrolled individuals treated with DESs implantation were evaluated by PL-11, using sequentially\nplatelet counting method. The primary end point was the occurrence of definite and probable stent thrombosis at\n2 years. The secondary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including\nall cause death, spontaneous myocardial infarction (MI), target vessel revascularization (TVR), and ischemic stroke.\nResults: A total of 1331consecutive patients were enrolled at our center. There were 91 patients (6.8 %) identified\nwith high platelet reactivity (HPR) on aspirin, and 437 patients (32.9 %) with HPR on clopidogrel. At 2-year followup,\nthe incidence of stent thrombosis was significantly higher in patients with HPR on aspirin (9.9 % vs. 0.4 %, p < 0.\n001), and HPR on clopidogrel (3.0 % vs. 0.1 %, p < 0.001). There were increased MACCE in the HPR on aspirin group\n(16.5 % vs. 8.5 %, p = 0.021), mainly driven by the higher all cause death (7.7 % vs. 1.6 %, p = 0.002) and MI (9.9 % vs.\n1.9 %, p < 0.001) in the HPR on aspirin group. Similarly, the rate of MACCE was higher in the HPR on clopidogrel\ngroup (12.4 % vs. 7.4 %, p = 0.004). No differences in all bleeding and hemorrhagic stroke were observed.\nConclusions: The present study demonstrated that high platelet reactivity on both aspirin and clopidogrel were\nassociated with incremental stent thrombosis following DESs implantation.
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