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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
GUTIERREZ-CADAVID, Xiomara and RUA-MOLINA, Diana C.. Meta-analysis. Frequency of platelet hyperreactivity in patients with DM and HTA undergoing PCI. Rev. Colomb. Cardiol. [online]. 2022, vol.29, n.2, pp.185-198. Epub May 19, 2022. ISSN 0120-5633. https://doi.org/10.24875/rccar.m22000146.
Objective:
To perform a metaanalyze of the frequency of platelet hyperreactivity for aspirin and clopidogrel with different aggregometers, in patients with diabetes mellitus and hypertension undergoing percutaneous coronary intervention.
Method:
Systematic review with metaanalysis using 40 searches in three multidisciplinary databases (PubMed, ScienceDirect and SciELO), following the phases of the PRISMA guide between the years 2005 and 2021. Reproducibility and methodological quality were guaranteed by two researchers using the STROBE guide. The analyzes were based on frequencies and odds ratio metaanalysis, using Epidat software with a 95% confidence interval.
Results:
22 studies were included, the frequency of platelet hyperreactivity was from 18.8% to 81.8% in the case of aspirin, and in the case of clopidogrel from 18.2% to 71.3%, which denotes an important heterogeneity. It was observed that the frequency of platelet hyperreactivity in diabetic patients ranged from 21% to 78.7% and in hypertensive patients from 17.6% to 76.8%, and finally it was observed that the platelet hyperreactivity was 1.38 times higher in diabetic patients than in those who were not and 1.23 times higher in hypertensive patients than in those who were not.
Conclusions:
Diabetes mellitus and hypertension as underlying pathologies in patients undergoing percutaneous coronary intervention are associated with the presence of platelet hyperreactivity, and this in turn –as shown by previous studies–, with the development of long-term vascular events, therefore a subsequent assessment. The procedure with platelet aggregometry tests would be potentially useful in the context of personalized therapy.
Keywords : Frequency; Platelet hyperreactivity; Diabetes; Hypertension; Percutaneous coronary intervention.