{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:33Z","timestamp":1787028633158,"version":"build-2736575974"},"reference-count":38,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deutsche Forschungsgesellschaft","award":["TRR 219"],"award-info":[{"award-number":["TRR 219"]}]},{"name":"Deutsche Forschungsgesellschaft","award":["Project-ID 322900939 [C-07, M03, M05]"],"award-info":[{"award-number":["Project-ID 322900939 [C-07, M03, M05]"]}]},{"name":"Deutsche Forschungsgesellschaft","award":["848146"],"award-info":[{"award-number":["848146"]}]},{"name":"Deutsche Forschungsgesellschaft","award":["101017424"],"award-info":[{"award-number":["101017424"]}]},{"name":"HORIZON2020 Programs TO_AITION","award":["TRR 219"],"award-info":[{"award-number":["TRR 219"]}]},{"name":"HORIZON2020 Programs TO_AITION","award":["Project-ID 322900939 [C-07, M03, M05]"],"award-info":[{"award-number":["Project-ID 322900939 [C-07, M03, M05]"]}]},{"name":"HORIZON2020 Programs TO_AITION","award":["848146"],"award-info":[{"award-number":["848146"]}]},{"name":"HORIZON2020 Programs TO_AITION","award":["101017424"],"award-info":[{"award-number":["101017424"]}]},{"name":"European Union","award":["TRR 219"],"award-info":[{"award-number":["TRR 219"]}]},{"name":"European Union","award":["Project-ID 322900939 [C-07, M03, M05]"],"award-info":[{"award-number":["Project-ID 322900939 [C-07, M03, M05]"]}]},{"name":"European Union","award":["848146"],"award-info":[{"award-number":["848146"]}]},{"name":"European Union","award":["101017424"],"award-info":[{"award-number":["101017424"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The clinical and prognostic implications of platelet reactivity (PR) testing in a P2Y12-inhibitor na\u00efve population are poorly understood. Objectives: This explorative study aims to assess the role of PR and explore factors that may modify elevated mortality risk in patients with altered PR. Methods: Platelet ADP-induced CD62P and CD63 expression were measured by flow-cytometry in 1520 patients who were referred for coronary angiography in the Ludwigshafen Risk and Cardiovascular Health Study (LURIC). Results: High- and Low-platelet reactivity to ADP were strong predictors of cardiovascular and all-cause mortality and risk equivalent to the presence of coronary artery disease. (High platelet reactivity 1.4 [95% CI 1.1\u20131.9]; Low platelet reactivity: 1.4 [95% CI 1.0\u20132.0]). Relative weight analysis indicated glucose control (HbA1c), renal function ([eGFR]), inflammation (high-sensitive C-reactive protein [hsCRP]) and antiplatelet therapy by Aspirin as consistent mortality risk modifiers in patients with Low- and High-platelet reactivity. Pre-specified stratification of patients by risk modifiers HbA1c (&lt;7.0%), eGFR (&gt;60 mL\/min\/1.73 m2) and CRP (&lt;3 mg\/L) was associated with a lower mortality risk, however irrespective of platelet reactivity. Aspirin treatment was associated with reduced mortality in patients with high platelet reactivity only (p for interaction: 0.02 for CV-death [&lt;0.01 for all-cause mortality]. Conclusions: Cardiovascular mortality risk in patients with High- and Low platelet reactivity is equivalent to the presence of coronary artery disease. Targeted glucose control, improved kidney function and lower inflammation are associated with reduced mortality risk, however independent of platelet reactivity. In contrast, only in patients with High-platelet reactivity was Aspirin treatment associated with lower mortality.<\/jats:p>","DOI":"10.3390\/jcm12051913","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T04:28:41Z","timestamp":1677558521000},"page":"1913","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Platelet Reactivity and Cardiovascular Mortality Risk in the LURIC Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2644-0744","authenticated-orcid":false,"given":"Martin","family":"Berger","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Dressel","sequence":"additional","affiliation":[{"name":"D-A-CH-Gesellschaft Pr\u00e4vention von Herz-Kreislauf-Erkrankungen e.V., 22765 Hamburg, Germany"},{"name":"Dr. Dressel Consulting, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus E.","family":"Kleber","sequence":"additional","affiliation":[{"name":"Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany"},{"name":"SYNLAB MVZ Humangenetik Mannheim GmbH, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6083-8946","authenticated-orcid":false,"given":"Winfried","family":"M\u00e4rz","sequence":"additional","affiliation":[{"name":"Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany"},{"name":"SYNLAB MVZ Humangenetik Mannheim GmbH, 68167 Mannheim, Germany"},{"name":"Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hellstern","sequence":"additional","affiliation":[{"name":"Center of Hemostasis and Thrombosis Zurich, 8006 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus","family":"Marx","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Sch\u00fctt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1161\/CIRCULATIONAHA.116.026995","article-title":"Platelets Express Activated P2Y12 Receptor in Patients With Diabetes Mellitus","volume":"136","author":"Hu","year":"2017","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e008522","DOI":"10.1161\/JAHA.118.008522","article-title":"ADP Platelet Hyperreactivity Predicts Cardiovascular Disease in the FHS (Framingham Heart Study)","volume":"7","author":"Puurunen","year":"2018","journal-title":"J. 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