{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:49:40Z","timestamp":1784695780683,"version":"3.55.0"},"reference-count":31,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019091","name":"Key Research and Development Project of Hunan Province","doi-asserted-by":"crossref","award":["2020SK2010"],"award-info":[{"award-number":["2020SK2010"]}],"id":[{"id":"10.13039\/501100019091","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Major New Drug Creation Project of China","award":["2020ZX09201-010"],"award-info":[{"award-number":["2020ZX09201-010"]}]},{"name":"Health Research Project of Hunan Provincial Health Commission","award":["W20243193"],"award-info":[{"award-number":["W20243193"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Much evidence has been provided that a therapeutic window of P2Y\n                      <jats:sub>12<\/jats:sub>\n                      receptor inhibition exists, which is highly significantly associated with ischemic and bleeding events. The therapeutic window for high-risk stratification after percutaneous coronary intervention (PCI) is lacking. We aimed to investigate the therapeutic window of P2Y\n                      <jats:sub>12<\/jats:sub>\n                      receptor inhibition in high-risk Chinese PCI patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this observational study, we analyzed 860 high-risk patients who were undergoing PCI. The primary endpoint was the correlation between vasodilator-stimulated phosphoprotein platelet reactivity index (VASP-PRI) values with bleeding and ischemic components in high-risk patients. The secondary endpoint was a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, urgent revascularization, and stroke at 12 months after the index procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among high-risk patients, VASP-PRI could significantly discriminate between PCI patients with and without ischemic events (area under the curve (AUC): 0.77; 95% CI [0.72\u20130.82];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). A VASP-PRI \u2265 0.45 was the optimal cutoff point to predict ischemic events (sensitivity: 86.6%; specificity: 63.6%). Similarly, VASP-PRI could also significantly discriminate between PCI patients with and without bleeding events ((AUC): 0.77; 95% CI [0.73\u20130.81];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). A VASP-PRI \u2264 0.24 was the optimal cutoff point to predict bleeding events (sensitivity: 72.1%; specificity: 70.3%). Multivariate analysis showed that VASP-PRI was an independent predictor of the risk of major adverse cardiovascular events (odds ratio: 10.67, 95% CI [3.78\u201330.08]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results suggest that high-risk Chinese PCI patients have a narrow therapeutic window. Within this window, high-risk patients are at lower risk for both ischemic and bleeding events. Platelet reactivity may have significant implications for personalized antiplatelet therapy in high-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20536","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T08:26:44Z","timestamp":1767947204000},"page":"e20536","source":"Crossref","is-referenced-by-count":2,"title":["A narrow therapeutic window of platelet P2Y\n                    <sub>12<\/sub>\n                    reactivity in high-risk Chinese percutaneous coronary intervention patients"],"prefix":"10.7717","volume":"14","author":[{"given":"Liying","family":"Gong","sequence":"first","affiliation":[{"name":"Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China"},{"name":"Department of the Critical Care Medicine, The Third Xiangya Hospital, Central South University, Changsha, 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengmei","family":"Wang","sequence":"additional","affiliation":[{"name":"Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiling","family":"Song","sequence":"additional","affiliation":[{"name":"Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Kuang","sequence":"additional","affiliation":[{"name":"Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsh, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoping","family":"Yang","sequence":"additional","affiliation":[{"name":"Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China"},{"name":"XiangYa School of Pharmaceutical Sciences, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"10.7717\/peerj.20536\/ref-1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.jcin.2011.12.009","article-title":"Different prognostic significance of high on-treatment platelet reactivity as assessed by the VerifyNow P2Y12 assay after coronary stenting in patients with and without acute myocardial infarction","volume":"5","author":"Ahn","year":"2012","journal-title":"JACC Cardiovascular 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