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Sairaku A.,Chugoku Workers Compensation Hospital | Nakano Y.,Hiroshima University | Eno S.,Chugoku Workers Compensation Hospital | Hondo T.,Chugoku Workers Compensation Hospital | And 3 more authors.
Journal of Atherosclerosis and Thrombosis | Year: 2011

Aim: We hypothesized that excessive suppression of platelet function due to antiplatelet therapy can increase the incidence of bleeding complications. The aim of the present study was to find whether we could predict bleeding events by measuring platelet function. Methods: We enrolled 743 subjects whose platelet function was measured using a whole blood aggregometer based on a screen filtration pressure method. Of these subjects, 551 (74.2%) were treated with some type of antiplatelet agent. The endpoints were bleeding or ischemic events requiring hospitalization or extension of hospital stay. We prospectively compared the platelet function of subjects with and without bleeding or ischemic events. Results: During 556±207 days of follow-up, 52 (7.0%) bleeding events and 20 (2.7%) ischemic events were observed. Kaplan-Meier analysis using the log-rank test revealed that an aggregation rate of <20% induced by 8 μM adenosine diphosphate (ADP) was significantly associated with a greater number of bleeding events (11.9% vs. 5.2%; p = 0.0007). Cox proportional hazards model showed that age >75 years (hazard ratio [HR], 1.78; 95% confidence interval [CI], 1.03-3.10; p = 0.039), estimated glomerular filtration rate <60 mL/min/1.73 m2 (HR, 1.82; 95% CI, 1.06-3.18; p = 0.031) and aggregation rate <20% induced by 8 μM ADP (HR, 2.18; 95% CI, 1.24-3.80; p = 0.0071) were independent predictors of bleeding events. Conclusions: Low platelet function demonstrated using a whole blood aggregometer was an independent predictor of bleeding complications. Source


Sairaku A.,Chugoku Workers Compensation Hospital | Eno S.,Chugoku Workers Compensation Hospital | Hondo T.,Chugoku Workers Compensation Hospital | Teragawa H.,West Japan Railway Company | And 4 more authors.
Hypertension Research | Year: 2010

We aimed to evaluate whether there was a difference in the arterial stiffness assessed by the cardio-ankle vascular index (CAVI) between patients with acute coronary syndrome (ACS) and those with stable angina pectoris (SAP). A total of 199 consecutive patients, 79 with ACS and 120 with SAP, who underwent emergency or elective coronary revascularization were enrolled. The CAVI was measured within 2 days after the procedures, and was compared between the ACS and SAP patients. As parameters related to arteriosclerosis, carotid intima-media thickness (IMT) and number of stenotic coronary vessels were also evaluated. Although IMT was significantly greater in SAP patients (2.1±1.1 vs. 2.4±0.9; P<0.022), CAVI was significantly higher in ACS patients (10.0±1.7 vs. 9.3±1.3; P<0.0012). After an adjustment for the clinical parameters with a significant difference between the two patient groups, CAVI remained significantly higher in ACS patients than in SAP patients (odds ratio 1.92, 95% confidence interval 1.30-3.02; P<0.0023). A multiple linear regression analysis revealed that age (Β0.44; P<0.0001) and ACS (Β0.3; P<0.0001) were the independent determinants of CAVI. A significant decrease in CAVI was observed at 6 months of follow-up as compared with the acute phase in 18 patients with ACS (10.91.6 vs. 10.01.5; P<0.019). In conclusion, CAVI was significantly and independently higher in patients with ACS than in those with SAP, which might result from a transient increase in the CAVI caused by acute myocardial ischemia. © 2010 The Japanese Society of Hypertension All rights reserved. Source

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