Impact of renal function on residual platelet reactivity and clinical outcomes in patients with acute coronary syndrome treated with clopidogrel

Abstract

Background: Chronic kidney disease (CKD) is a common comorbidity in patients with acute coronary syndrome (ACS) and may potentially influence platelet function. Hypothesis: We explored the influence of renal function on platelet reactivity to investigate whether high residual platelet reactivity (HRPR) is associated with cardiovascular events. Methods: ACS patients treated with aspirin and clopidogrel were prospectively enrolled. Patients were categorized into two groups on the basis of baseline estimated glomerular filtration rate (eGFR): non-CKD (eGFR ≥60 mL/min/1.73 m2) and CKD (eGFR <60 mL/min/1.73 m2). Platelet function was measured by thromboelastography ≥5 days after maintenance dual antiplatelet therapy. Major adverse clinical events (MACEs) were collected at 1 year after discharge. Results: There were 282 non-CKD patients and 212 CKD patients. A significant difference in median MAADP value was observed between the two groups (15.0 mm vs. 31.3 mm, p