Abstract 10481: The Effect of Current Smoking on Platelet Reactivity Measures by Point-of-Care Methods in Patients Treated With and Without Clopidogrel

Abstract

Introduction: Smoking is associated with worse response to P2Y12 inhibitors. However, the relationship between smoking, platelet reactivity (PR) and traditional risk factors for atherosclerosis is unclear. Hypothesis: To analyze the relationship between smoking, PR and risk factors for atherosclerosis. Methods: A prospective databank of 13 research protocols was retrospectively analyzed. Among 1260 patients included in the analysis, 299 were smokers; 721 had acute coronary syndromes (521 with clopidogrel), and 539 had stable coronary artery disease (4 with clopidogrel). The association between smoking and PR analyzed by Multiplate-ADP (MPADP) and VerifyNow-PRUTest (VNPRU), inflammatory markers (leukocytes and hs-C-reactive protein), creatinine, HbA1c, total cholesterol, HDL-c, LDL-c and triglycerides, was analyzed in univariate and multivariable models. PR results were analyzed as continuous and categorical variables (bellow or above the median). Results: Unadjusted results for the comparison between smokers and non-smokers are depicted in the Table and Figure. In adjusted models, the significant associations between smoking and PR were maintained: 1) MPADP Odds-Ratio (OR)=0.984, p<0.001; 2) VNPRU OR=0.996, P=0.008; 3) MPADPCAT>MD OR=0.450, P<0.001; 4) VNADPCAT>MD OR=0.408, p<0.001; 5) ADPMEDIAN>MD OR=0.394, p<0.001). HDL-c (negative) was the only risk factor for atherosclerosis that correlated independently with smoking in all adjusted models, with leukocytes (positive) and creatinine (negative) showing correlation in 4 of the 5 models. Conclusion: Smoking is independently associated with lower PR and HDL-c levels.