Platelet function, coagulation and fibrinolysis in patients with previous coronary and cerebrovascular ischemic events
Clinics
;
74: e1222, 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-1039547
ABSTRACT
OBJECTIVES:
Ischemic stroke (IS) or transient ischemic attack (TIA) history is present in 4-17% of patients with coronary artery disease (CAD). This subgroup of patients is at high risk for both ischemic and bleeding events. The aim of this study was to determine the role of platelet aggregability, coagulation and endogenous fibrinolysis in patients with CAD and previous IS or TIA.METHODS:
A prospective case-control study that included 140 stable CAD patients divided into two groups the CASE group (those with a previous IS/TIA, n=70) and the CONTROL group (those without a previous IS/TIA, n=70). Platelet aggregability (VerifyNow Aspirin® and VerifyNow P2Y12®), coagulation (fibrinogen and thromboelastography by Reorox®) and endogenous fibrinolysis (D dimer and plasminogen activator inhibitor-1) were evaluated.RESULTS:
Patients in the CASE group presented significantly higher systolic blood pressure levels (135.84±16.09 vs 123.68±16.11, p<0.01), significantly more previous CABG (25.71% vs 10%, p=0.015) and significantly higher calcium channel blocker usage (42.86% vs 24.29%, p=0.02) than those in the control group. In the adjusted models, low triglyceride values, low hemoglobin values and higher systolic blood pressure were significantly associated with previous IS/TIA (CASE group). Most importantly, platelet aggregability, coagulation and fibrinolysis tests were not independently associated with previous cerebrovascular ischemic events (CASE group).CONCLUSION:
Platelet aggregability, coagulation and endogenous fibrinolysis showed similar results among CAD patients with and without previous IS/TIA. Therefore, it remains necessary to identify other targets to explain the higher bleeding risk presented by these patients.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Blood Coagulation
/
Coronary Artery Disease
/
Ischemic Attack, Transient
/
Platelet Aggregation
/
Stroke
/
Fibrinolysis
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2019
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Faculdade de Medicina da Universidade de Uberlandia/BR
/
Universidade de Sao Paulo/BR
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