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  • Diabetes mellitus and carotid artery plaques exhibiting high-intensity signals on MR angiography are related to increased platelet reactivity after carotid artery stenting

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Basic science
Case series
Diabetes mellitus and carotid artery plaques exhibiting high-intensity signals on MR angiography are related to increased platelet reactivity after carotid artery stenting
  1. Masanori Tsujimoto,
  2. Yukiko Enomoto,
  3. Jouji Kokuzawa,
  4. Toru Iwama
  1. Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
  1. Correspondence to Dr Masanori Tsujimoto, Department of Neurosurgery, Gifu University Graduate School of Medicine, Yanagido, Gifu city, Gifu 501-1194, Japan; masanori-t.117{at}hotmail.co.jp

Abstract

Background Increased platelet reactivity after carotid artery stenting (CAS) may cause thromboembolic complications.

Objective This study aimed to investigate the incidence of increased platelet reactivity after CAS and to determine the factors related to it.

Methods Patients who underwent CAS were recruited prospectively. They received pre-procedural antiplatelet therapy comprising some combination of aspirin (100 mg/day), clopidogrel (75 mg/day), and/or cilostazol (200 mg/day) for a minimum of 7 days. ADP- and collagen-induced platelet aggregation were measured before and 4 days after CAS. Changes in platelet reactivity were reported as changes in the categorized platelet reactivity grade based on the effective dose 50%. Clinical characteristics of patients with and without increased platelet reactivity were compared.

Results Among 38 consecutive patients who underwent CAS, 18 (47%) exhibited increased platelet reactivity. Diabetes mellitus (OR 15.0; 95% CI 2.1 to 106.5; p=0.007) and carotid artery plaques exhibiting high-intensity signals (HIS) on time-of-flight MR angiography (TOF-MRA) (OR 25.2; 95% CI 2.0 to 316.2; p=0.013) were independently associated with increased platelet reactivity in a multivariate analysis.

Conclusions Increased platelet reactivity occurred in nearly half of the studied patients subjected to CAS and was independently associated with diabetes mellitus and carotid artery plaques exhibiting HIS on TOF-MRA.

  • Platelets
  • Stent

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/neurintsurg-2016-012419

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    Footnotes

    • Funding This study was supported by Grants-in-Aid for Scientific Research Grant Number 25861267 and 16K20001 from the Japan Society for the Promotion of Science.

    • Competing interests None declared.

    • Ethics approval Ethics approval was obtained from the Committee of Ethics in Gifu University Graduate School of Medicine.

    • Provenance and peer review Not commissioned; externally peer reviewed.