Clinical Implications of Antiplatelet Therapy in Obese Patients Post-PCI: A Study of 155 Patients

• MUHAMMAD KASHIF ZAFAR

  Associate Professor of Cardiology Cardiology Department, Punjab institute of cardiology, Lahore

  Author

• SHAHZAD SHOUKAT

  MBBS, FCPS Cardiology Assistant Professor of Cardiology Cardiology Department, Punjab institute of Cardiology, Lahore.

  Author

Background: Obesity is a major cardiovascular risk factor, which has normally been linked to unfavourable chances in patients that undergo percutaneous coronary intervention (PCI). Antiplatelet therapy (APT) is essential in the prevention of thrombotic events; however, obesity can interfere with the pharmacodynamics and pharmacokinetics of this treatment. The purpose of this study was to conduct an assessment of antiplatelet therapy in obese patients undergoing PCI.

Methods: This study enrolled 155 obese patients who were undergoing PCI. We examined their reaction to dual antiplatelet therapy (DAPT) comprising aspirin and P2Y12 antiplatelet drugs (clopidogrel, ticagrelor, or prasugrel) and followed the clinical endpoints of bleeding complications, thrombotic events, and restenosis. The VerifyNow^@ assay was used to determine the functioning of platelets.

Results: The study found that ticagrelor was much more effective than clopidogrel in reducing platelet reactivity in patients. Ticagrelor therapy was related to fewer major adverse cardiovascular events (MACE) and stent thrombosis. But the danger of bleeding complications was more in patients on ticagrelor. Prasugrel, however, also showed the same degree of effectiveness like ticagrelor with a low rate of bleeding.

Conclusion: Ticagrelor and prasugrel were more effective in patients with obesity during PCI but the incidence of bleeding occurred more often. Modifications of the dose according to body weight and platelet reactivity testing are suggested to optimize therapy in this high-risk population.

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