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Comparative Study
. 2019 Sep 26:74:e1222.
doi: 10.6061/clinics/2019/e1222. eCollection 2019.

Platelet function, coagulation and fibrinolysis in patients with previous coronary and cerebrovascular ischemic events

Carlos José Dornas Gonçalves Barbosa  1   2 , Renata de Souza Barreiros  1 , André Franci  1 , Flávia Bittar Brito Arantes  3 , Remo Holanda de Mendonça Furtado  1 , Célia Maria Cassaro Strunz  1 , Tânia Rúbia Flores da Rocha  4 , Luciano Moreira Baracioli  1 , José Antônio Franchini Ramires  1 , Roberto Kalil Filho  1 , José Carlos Nicolau  1
Affiliations
Comparative Study

Platelet function, coagulation and fibrinolysis in patients with previous coronary and cerebrovascular ischemic events

Carlos José Dornas Gonçalves Barbosa et al. Clinics (Sao Paulo). .

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.

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Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
Inclusion Flowchart. ACS- acute coronary syndrome, IS- ischemic stroke, TIA- transient ischemic attack, GFR- glomerular filtration rate, pts- patients.
See this image and copyright information in PMC

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