Increased platelet reactivity after heart transplantation
Bibliographic record
Abstract
The role of antiplatelet therapy following heart transplantation (HT) is unclear. Ex-vivo studies suggest increased platelet hyperaggregability after HT. Recent studies suggest that early aspirin therapy is associated with improved survival and lower rates of cardiac allograft vasculopathy (CAV). We examined: (1) the prevalence of increased platelet reactivity on aspirin and clopidogrel post-HT, (2) platelet reactivity post-clopidogrel treatment in aspirin-resistant patients, and (3) the relationship between platelet reactivity and outcomes. HT patients on aspirin and/or clopidogrel who underwent coronary angiography in 2015–2018 were assessed using the VerifyNow aspirin and/or P2Y12 assay. High on-treatment platelet reactivity (HPR) to aspirin and clopidogrel were defined by aspirin reaction unit (ARU) > 550 and P2Y12 reaction unit (PRU) > 208. Patients with HPR to aspirin were switched to clopidogrel for 7 days, then reassessed with the P2Y12 assay. Platelet reactivity was assessed in 76 patients at 4.6 (IQR 2.2-9.4) median years post-HT. ARU was assessed in 71 patients and PRU in 16 patients. Median ARU was 471 (IQR 419-537) and PRU 186 (IQR 120-244). The prevalence of HPR to aspirin and clopidogrel were 18% and 37%, respectively, which is comparable to patients with coronary artery disease. 45% of patients with HPR to aspirin also had HPR to clopidogrel. There was no difference in aspirin HPR prevalence between patients with and without CAV. There is increased platelet reactivity despite treatment with aspirin or clopidogrel following HT. Further evaluation may determine whether increased platelet reactivity is associated with adverse outcomes including the development of CAV.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".