The pre-procedural platelet state predicts clinical recurrence after coronary angioplasty

Percutaneous transluminal coronary angioplasty is an established therapy fo r coronary artery disease, but restenosis still occurs at a rate of 25%-40% . The aim of this study was to investigate the acute effect of percutaneous transluminal coronary angioplasty on platelet function and the relationshi p between platelet function and clinical recurrence, Spontaneous platelet a ggregation was assessed before and after successful coronary angioplasty in 155 patients (120 men, 35 women). Patients were followed for a mean time o f 20 months; follow-up angiography was performed only in patients with clin ical recurrence. In 122 of 155 patients (79%) a significant increase in spo ntaneous platelet aggregation was observed immediately after coronary angio plasty. Baseline spontaneous platelet aggregation in platelet-rich plasma w as significantly lower in patients with clinical recurrence than in those w ithout (P<0.05), Kaplan-Meier event-free survival estimate showed a signifi cant difference in clinical recurrence between patients with spontaneous pl atelet aggregation in platelet-rich plasma below and above the first quinti le (P<0.05) with a relative risk of 2.5. In conclusion, these results indic ate that percutaneous transluminal coronary angioplasty enhances spontaneou s platelet aggregation and that the platelet state before coronary angiopla sty affects the risk of clinical recurrence after the procedure.