Background: Platelet aggregation monitoring in diabetic patients treated with coronary interventions (PCI) for an\nacute coronary syndrome (ACS) is a promising way of optimizing treatment and outcomes in this high risk group.\nThe aim of the study was to verify whether clopidogrel response measured by Multiplate analyzer (ADPtest) in\ndiabetic ACS patients treated with PCI predicts the risk of stent thrombosis or cardiovascular mortality and bleeding.\nMethods: Into this prospective, observational study 206 elective PCI patients were enrolled. Two cutoff points of\nADPtest were used in analysis to divide patients into groups. One (345 AU x min) was calculated based on ROC\ncurve analysis; this cutoff provided the best ROC curve fit, although it did not reach statistical significance. The\nother (468 AU x min) was accepted based on the consensus of the Working Group on On-Treatment Platelet\nReactivity. The risk of stent thrombosis and mortality was assessed using Cox regression analysis and Kaplan-Meier\ncurves.\nResults: The risk of stent thrombosis was higher in the group of patients with impaired clopidogrel response for\neither cutoff value (for >354 AU x min - HR 12.33; 95% CI 2.49ââ?¬â??61.1; P = 0.002). Cardiovascular mortality was also\nhigher in the impaired clopidogrel response group (for >354 AU x min - HR 10.58; 95% CI 2.05ââ?¬â??54.58; P = 0.005).\nWe did not find a clear relation of increased clopidogrel response to the risk of bleeding.\nConclusions: The results of this study show that in diabetic ACS patient group treated with PCI an impaired\nplatelet response to clopidogrel measured by the Multiplate analyzer results in increased risk of stent thrombosis\nand cardiac death.
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