Role of Platelet Reactivity Index (PRI) in Antiplatelet Therapy and its Association with Vasodilator Stimulated Phosphoprotein (VASP) for Iraqi Patient Undergoing PCI.

Abstract

Background: VASP, an actin-regulatory protein family member, controls platelet adhesion .Ticagrelor isthe first member of a brand-new agent of chemicals, thecyclopentyltriazolopyrimidines, is Ticagrelor. ADP's prothrombotic effects can be prevented by Ticagrelor's ability to block the platelet P2Y12 receptor, just as the thienopyridines. Dissimilar the thienopyridines, which are irreversible inhibitors , reversibly binding to the P2Y12 receptor, Ticagrelor almost entirely blocks ADP-stimulated platelet aggregation, as demonstrated in vitro. Because it does not require metabolic activation, Ticagrelor is an alternative to the thienopyridines. All patients receiving Ticagrelor achieve adequate antiplateleteffects. Objective: Inthis study, we examined the roleof platelet reactivity index (PRI) in antiplatelet treatment and its association with vasodilator stimulated phosphoprotein (VASP) for Iraqi patient undergoing percutaneouscoronary intervention (PCI). Methods: In this study, patients who were eligible for PCI were included. At least two weeks after a 90-mg dose of ticagrelor was administered following PCI, blood samples were collected from patients. Vasodilator-stimulated phosphoprotein phosphorylation assay (VASP-P) was used to detect the inhibition percentage of platelet adhesion. Consistently high or low levels of platelet activationon therapy can be identified by the evaluation ofplatelet reactive index (PRI) using the VASPELISA assay.

Results: The body mass index (BMI) was significant higher in patients with coronary heartdisease contrasted to thecontrol group (P < 0.001). There was a significant difference inthe platelets count in patientswith coronary heart disease in comparison tothe control group (p<0.05). The study groups were categorized according to the PRI-VASP % and it was found that (26.46 ± 0.75) of the patients while on (80.04 ± 0.98) of the control. The PRI-VASP % in patients was a strong significantly increased in comparison to PRI-VASP % in control group (26.46 ± 0.75versus 80.04 ± 0.98, P<0.001) respectively. According to the findings, the subjects were grouped into the mean of serum VASP, and it was found that 139.56 ± 13.66 ng/L of the patients while on 238.85 ± 20.74 ng/L of the control. The mean of VASP level in patients was a strong significantly decreased in comparison to mean of serum VASP level mean in control group (24.97 ± 0.33 ng/Lversus 22.55 ± 0.28 ng/L P<0.001) respectively. Conclusion: Ticagrelor medication protects all patients, according to present findings in this study in Iraqi population. Also, there was no association between VASP phosphorylation and VASP.