052 Cardiovascular mortality in chronic kidney disease patients undergoing percutaneous coronary intervention is mainly related to impaired P2Y12 inhibition by clopidogrel

ObjectivesTo determine whether low platelet response to the P2Y12 receptor antagonist clopidogrel as assessed by VAsodilator Stimulated Phosphoprotein flow cytometry test (VASP-FCT) has the same deleterious clinical impact in patients with or without chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI).BackgroundWhilst both CKD and impaired platelet responsiveness to clopidogrel are strong predictors of unfavourable outcome after PCI, the deleterious impact of their association is unknown. The platelet VASP-FCT assay is specific of the P2Y12 ADP receptor-pathway. In this test, platelet activation is expressed as Platelet Reactivity Index (PRI).Methods440 unselected patients (CKD: 126 (eGFR<60ml/min/1.73m2), NoCKD: 314 eGFR>60ml/min/1.73m2) undergoing urgent (n = 336) or planned (n = 104) PCI were prospectively enrolled. In each sub-group, patients were classified as low-responders (LR: PRI≥61%) and responders (R: PRI