{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:49:02Z","timestamp":1790092142545,"version":"4.0.1"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,5,18]]},"abstract":"\n Background<\/jats:title>\n \n The balance between ischemic and bleeding events and their association with platelet reactivity in patients receiving antiplatelet therapy after percutaneous coronary intervention (\n PCI<\/jats:styled-content>\n ), which differs among regions, is not fully evaluated for East Asians. We examined ischemic\/bleeding events and platelet reactivity in Japanese patients undergoing\n PCI<\/jats:styled-content>\n and determined associations between high\/low platelet reactivity and clinical outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n PENDULUM<\/jats:styled-content>\n (Platelet Reactivity in Patients with Drug Eluting Stent and Balancing Risk of Bleeding and Ischemic Event) is a prospective, multicenter registry of Japanese patients with\n PCI<\/jats:styled-content>\n . Primary end points were incidence of first major adverse cardiac and cerebrovascular events (\n MACCE<\/jats:styled-content>\n ) and first major bleeding events at 12\u00a0months post\u2010\n PCI<\/jats:styled-content>\n . Platelet reactivity (P2Y\n 12<\/jats:sub>\n reaction unit\n [PRU<\/jats:styled-content>\n ] value) was measured at 12 to 48\u00a0hours post\u2010\n PCI<\/jats:styled-content>\n ; patients were grouped as having high\n PRU<\/jats:styled-content>\n (>208), optimal\n PRU<\/jats:styled-content>\n (>85 to \u2264208), and low\n PRU<\/jats:styled-content>\n (\u226485).\n MACCE<\/jats:styled-content>\n and major bleeding occurred in 4.4% and 2.8% of 6267 patients, respectively. The mean\u00b1SD\n PRU<\/jats:styled-content>\n value was 182.1\u00b177.1.\n MACCE<\/jats:styled-content>\n was significantly higher in the high\n PRU<\/jats:styled-content>\n (5.7%; n=2227) versus the optimal\n PRU<\/jats:styled-content>\n group (3.6%; n=3002). The hazard ratio (HR) for high\n PRU<\/jats:styled-content>\n versus optimal\n PRU<\/jats:styled-content>\n level was significantly higher for\n MACCE<\/jats:styled-content>\n (adjusted HR, 1.53; 95% CI, 1.14\u20132.06 [\n P<\/jats:italic>\n =0.004]); stent thrombosis followed the same trend. Incidence of major bleeding did not differ significantly between groups. A high\n PRU<\/jats:styled-content>\n level was significantly associated with\n MACCE<\/jats:styled-content>\n in both patients with and patients without acute coronary syndrome.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n These real\u2010world data suggest an association between high platelet reactivity and cardiovascular events in Japanese patients undergoing\n PCI<\/jats:styled-content>\n . The trend was the same in both patients with and patients without acute coronary syndrome.\n <\/jats:p>\n <\/jats:sec>\n \n REGISTRATION<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n https:\/\/www.umin.ac.jp\/ctr<\/jats:ext-link>\n . Unique identifier:\n UMIN<\/jats:styled-content>\n 000020332.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.015439","type":"journal-article","created":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T09:49:22Z","timestamp":1589276962000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Relationship Between Platelet Reactivity and Ischemic and Bleeding Events After Percutaneous Coronary Intervention in East Asian Patients: 1\u2010Year Results of the PENDULUM Registry"],"prefix":"10.1161","volume":"9","author":[{"given":"Masato","family":"Nakamura","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazushige","family":"Kadota","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kurashiki Central Hospital Kurashiki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sakurakai Takahashi Hospital Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junji","family":"Kanda","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asahi General Hospital Asahi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Anzai","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ota Memorial Hospital Ota Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiovascular Center Ogikubo Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshisato","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Cardiology Miyazaki Medical Association Hospital Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Yasaka","sequence":"additional","affiliation":[{"name":"Department of Cardiology Himeji Cardiovascular Center Himeji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itaru","family":"Takamisawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sakakibara Heart Institute Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women\u2019s Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Cardiology Rinku General Medical Center Izumisano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Harada","sequence":"additional","affiliation":[{"name":"Medical Science Department Daiichi Sankyo Co., Ltd. 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Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raisuke","family":"Iijima","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kawasaki Medical School Kurashiki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics School of Medicine Toho University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the PENDULUM Registry Investigators*","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.11.048"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30397-5"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.0063"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.02.064"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz372"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.03.034"},{"issue":"9","key":"e_1_3_2_8_2","first-page":"573","article-title":"Guidelines for the management of patients with acute myocardial infarction (ST\u2010elevation type)","volume":"69","author":"Goto Y","year":"2011","unstructured":"Goto Y. 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