Predictive Value of the COP-INH Score for Adverse Cardiovascular Events After PCI in ACS Patients

Junping Ou,1,* Zhongwen Liu,1,* Qingyi Wang,2,* Yuping Wang,2 Xiaolin Li1,2 1Department of Cardiology, Ji’an Central People’s Hospital, Ji’an, 343009, People’s Republic of China; 2Medical School, Rehabilitation Medicine Department, Jinggangshan University, Ji’an, 343009, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaolin Li, Medical School, Rehabilitation Medicine Department, Jinggangshan University, Ji’an, 343009, People’s Republic of China, Tel +86 13979609896, Email [email protected]: Patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) require long-term antiplatelet therapy to prevent in-stent restenosis. However, the efficacy of this treatment can be compromised by factors, such as aspirin resistance and variable clopidogrel reactivity, potentially leading to adverse clinical outcomes. This study aims to assess the clinical significance of detecting platelet reactivity to P2Y12 receptor inhibitors and platelet inhibition rates in patients with ACS post-PCI and assessing the relation of the occurrence of major adverse cardiac events (MACE).Methods: We employed the VerifyNow P2Y12 system to assess platelet reactivity to P2Y12 receptor inhibitors and platelet inhibition rates. The combination of P2Y12 reaction unit and percentage of platelet inhibition [%INH] (COP-INH) score was calculated 30 days post-PCI for patients with ACS. The primary endpoint events included cardiovascular death, non-fatal myocardial infarction, and target vessel revascularization at 1-year follow-up. We analyzed the correlation between the COP-INH score and primary endpoint events.Results: The incidence of major adverse cardiovascular events was significantly higher in patients with a COP-INH score of 2, compared with those with a score of 1 or 0 (20.31% vs 7.69%, p=0.015). Multivariate analysis revealed that a COP-INH score of 2 is a predictive indicator of major adverse cardiovascular events post-PCI in patients with ACS (p=0.027). In contrast, scores of 1 or 0 showed no significant predictive value.Conclusion: The COP-INH score may serve as a potential predictor for long-term adverse cardiovascular events following PCI in patients with ACS.Keywords: platelet reactivity, clopidogrel, acute coronary syndrome, percutaneous coronary intervention, prognosis