Turk Kardiyol Dern Ars. 2018; 46(5): 349-357 | DOI: 10.5543/tkda.2018.67817
Association between high on-treatment platelet reactivity to clopidogrel and hepatosteatosis in patients undergoing elective stent implantation
, Ahmet İlker Tekkeşin1
, Hakan Barutca2
, Özlem Yıldırımtürk1
, Emrah Bozbeyoğlu1
, Yasin Çakıllı1
, Özge Güzelburç1
, Seviye Bora Şişman2
, Göksel Çinier1
, Sinan Şahin2
, Ahmet Taha Alper11
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey2
Department of Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
OBJECTIVE The present study is an investigation of the association between high on-treatment platelet reactivity to clopidogrel (HTPRC) and hepatosteatosis in patients who had elective stent implantation due to coronary artery disease.
METHODS A total of 190 consecutive patients who underwent an elective coronary stent implantation due to coronary artery disease were prospectively enrolled in the study. Eligible patients were given a 300 mg loading dose of clopidogrel before percutaneous coronary intervention. All of the patients underwent an ultrasound assessment for fatty liver. The patients were divided into 2 groups according to the detection of HTPRC: patients with HTPRC and patients without HTPRC.
RESULTS HTPRC was present in 54.2% (103 of 190 patients) of the total study population. The age and body mass index data were similar between the 2 groups. In all, 111 (58.6%) patients had hepatosteatosis. The HTPRC ratio was statistically higher in female patients (p=0.032). Hepatosteatosis was significantly greater in patients with HTPRC (p<0.001); 84 (81.6%) patients with HTPRC had hepatosteatosis (p=0.001). There was also a statistically significant association between the hepatosteatosis grade and HTPRC (p<0.001). The percentage of HTPRC was greater in patients with ≥grade 2 hepatosteatosis than grade 1 (p<0.001). Logistic regression analysis indicated that hepatosteatosis (odds ratio: 9.403, 95% confidence interval: 4.51919.566; p<0.001), fasting blood glucose, and hypertension were independent predictors of HTPRC.
CONCLUSION To the best of our knowledge, this is the first study to demonstrate a relationship between hepatosteatosis and HTPRC.
Coronary artery disease, hepatosteatosis; high on-clopidogrel platelet reactivity; percutaneous coronary intervention.
How to cite this article
Yalçın Velibey, Ahmet İlker Tekkeşin, Hakan Barutca, Özlem Yıldırımtürk, Emrah Bozbeyoğlu, Yasin Çakıllı, Özge Güzelburç, Seviye Bora Şişman, Göksel Çinier, Sinan Şahin, Ahmet Taha Alper. Association between high on-treatment platelet reactivity to clopidogrel and hepatosteatosis in patients undergoing elective stent implantation. Turk Kardiyol Dern Ars. 2018; 46(5): 349-357
Corresponding Author: Yalçın Velibey, Türkiye