Abstract
PurposeObese patients exhibit an overall increased platelet reactivity and a reduced sensitivity to antiplatelet therapy. The aim of this study is to evaluate the platelet reactivity measured by impedance aggregometry in overweight and obese patients and chronic coronary syndrome (CCS) that were treated with dual antiplatelet therapy (DAPT).MethodsPlatelet aggregation was assessed by impedance aggregometry in patients with CCS receiving DAPT (aspirin plus clopidogrel). We compared the platelet reactivity in patients with a normal weight versus overweight or obese patients. Furthermore, the correlation between the body mass index (BMI) and adenosine diphosphate- (ADP-) or thrombin receptor-activating peptide- (TRAP-) dependent platelet aggregation was analyzed.Results64 patients were included in the study of which 35.9% were patients with normal weight. A higher ADP- and TRAP-dependent platelet reactivity was observed in overweight and obese patients (ADP: median 27 units (U) [IQR 13–39.5] vs. 7 U [6–15], p < 0.001 and TRAP: 97 U [73–118.5] vs. 85 U [36–103], p = 0.035). Significant positive correlations were observed between agonist-induced platelet reactivity and BMI.ConclusionDespite the use of DAPT, a higher platelet reactivity was found in overweight and obese patients with CCS. If these patients will benefit from treatment with more potent platelet inhibitors, it needs to be evaluated in future clinical trials.
Highlights
Obesity is an important modifiable risk factor that contributes to the pathogenesis of diabetes, cancer, and cardiovascular diseases (CVD), among other entities [1, 2]
The present study aims to evaluate the difference of the adenosine diphosphate- (ADP-) and thrombin receptoractivating peptide- (TRAP-) induced platelet aggregation measured by impedance aggregometry between overweight and obese patients with chronic coronary syndrome (CCS) in comparison with those CCS patients who have a normal body mass index (BMI)
These findings point to the presence of heightened platelet reactivity in CCS patients that are overweight or obese, despite concurrent treatment with aspirin and clopidogrel
Summary
Obesity is an important modifiable risk factor that contributes to the pathogenesis of diabetes, cancer, and cardiovascular diseases (CVD), among other entities [1, 2]. It is a risk factor for arterial and venous thrombotic events. The link between obesity and CVD can be explained by the presence of a pro-inflammatory and pro-thrombotic state in this group of patients [1, 3]. Possible mechanisms that may explain the increased thrombotic risk in obese patients are due to altered expression of profiles of proteins of the coagulation and fibrinolytic cascade as well as an increased platelet reactivity [4]. The change in platelet function in obesity is reflected by elevated levels of platelet activation markers such as mean platelet volume, thromboxane B2 metabolites, circulating levels of platelet microparticles, soluble p-selectin, and platelet derived CD40L [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
