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

Yalçýn Velibey¹, Ahmet Ýlker Tekkeþin¹, Hakan Barutca², Özlem Yýldýrýmtürk¹, Emrah Bozbeyoðlu¹, Yasin Çakýllý¹, Özge Güzelburç¹, Seviye Bora Þiþman², Göksel Çinier¹, Sinan Þahin², Ahmet Taha Alper^1
1Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Ýstanbul, Turkey
²Department of Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Ýstanbul, 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: 4.519–19.566; 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.

Keywords: Coronary artery disease, hepatosteatosis; high on-clopidogrel platelet reactivity; percutaneous coronary intervention.

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