Prospective analysis after coronary-artery bypass grafting: Platelet GP IIIa polymorphism (HPA-1b/PIA2) is a risk factor for bypass occlusion, myocardial infarction, and death

Recently. we have demonstrated that human platelet antigen 1b (HPA-1b or P1 (A2)) is a hereditary risk factor for platelet thrombogenicity leading to p remature myocardial infarction in preexisting coronary artery disease. Howe ver. HPA-1b does not represent a risk factor for coronary artery disease it self. The aim of our present study was to evaluate the role of HPA-1b on th e outcome in patients after coronary-artery bypass surgery. We prospectivel y determined the HPA-1 genotype in 261 consecutive patients prior to saphen ous-vein coronary-artery bypass grafting. The patients were followed for on e year. Among patients with bypass occlusion, myocardial infarction, or dea th more than 30 days after surgery, the prevalence of HPA-1b was significan tly higher than among patients without postoperative complications (60 perc ent. 6/10, vs. 24 percent, 58/241, p <0.05, odds ratio 4.7). Using a stepwi se logistic regression analysis with the variables HPA-1b, age, sex, body m ass index, smoking (pack-years), hypertension, diabetes, cholesterol and tr iglyceride concentration. only HPA-1b had a significant association with by pass occlusion. myocardial infarction, or death after bypass surgery (p = 0 .019. odds ratio 4.7). this study shows that HPA-1b is a hereditary risk fa ctor for bypass occlusion. myocardial infarction, or death in patients afte r coronary-artery bypass surgery.