Turk Kardiyol Dern Ars. Ahead of Print: TKDA-67817 | DOI: 10.5543/tkda.2018.67817

Association between high on-treatment platelet reactivity of 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
1Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
²Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Department of Radiology, Istanbul, Turkey

OBJECTIVE
Present study aimed to investigate the association between high on-treatment platelet reactivity of clopidogrel (HTPRC) and hepatosteatosis in patients who had elective stent implantation due to coronary artery disease.


METHODS
We prospectively enrolled 190 consecutive patients who had coronary stents implanted electively due to coronary artery disease. Eligible patients were given 300 mg loading dose of clopidogrel before percutaneous coronary intervention (PCI). All patients had undergone ultrasound examination for detection of fatty liver. Patients were divided into two groups according to detection of HTPRC: patients with HTPRC and patients without HTPRC.


RESULTS
HTPRC occurred in 54.2 % (103 out of 190 patients) of overall study population. Age and body mass index levels were similar between two groups. HTPRC ratio was statistically higher in female patients (p = 0.032). One hundred and eleven (58.6 %) patients had hepatosteatosis. Hepatosteatosis was significantly higher in patients with HTPRC (p < 0.001). Eighty four (81.6%) patients with HTPRC had hepatosteatosis (p = 0.001). However, only 27 (31%) patients without HTPRC had hepatosteatosis. There was also statistically significant association between hepatosteatosis grade and HTPRC (p< 0.001). The percentage of HTPRC was higher in patients with ≥ grade 2 hepatosteatosis than in grade 1 (p < 0.001).In logistic regression analysis, hepatosteatosis [odds ratio (OR) 9.403, 95 % CI 4.519 - 19.566, p < 0.001)], fasting blood glucose and hypertension were independent predictors of HTPRC.


CONCLUSION
Present study is the first report that demonstrates the association between hepatosteatosis and HTPRC.

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

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