Prognostic value of high on-treatment platelet reactivity

We have read the article by Tekkesin et al. (1) entitled “The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions” published in Anatol J Cardiol 2016; 16: 967-73 with great interest. A meta-analysis of 17 studies consisting of 20839 patients indicated that clopidogrel-treated patients with high on-treatment platelet reactivity (HTPR) had a 2.7-fold higher risk for stent thrombosis (ST) and a 1.5-fold higher risk for mortality following percutaneous coronary intervention (PCI) (2). Lack of association of ST and mortality with HTPR in the present study could be linked to the following reasons. Firstly, study population was heterogeneous in stent type and generation. Implantations of bare-metal stents (BMS) and drug-eluting stents (DES) were mentioned without further detail.