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May 31, 2026DiseasesOpen Access

Platelet reactivity shows a U-shaped association with cardiovascular mortality in CAD patients.

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Why the study?

The relationship between platelet reactivity measured as PRU and cardiovascular mortality in CAD remains incompletely characterized, particularly regarding potential non-linear associations.

Is there a non-linear association between platelet reactivity (PRU) and cardiovascular mortality in patients with CAD?

Population

1000 patients with angiographically confirmed CAD treated at a tertiary cardiology center in Kazakhstan

Comparison

Varying platelet reactivity levels measured as PRU

Design

Retrospective observational cohort study

Key result

Platelet reactivity (PRU) exhibited a significant U-shaped association with cardiovascular mortality in CAD patients, whereas conventional linear models showed no association (OR ~1.00; p>0.05).

Authors

ШЖШ.Б. ЖангеловаOSOrazbek SakhovLALyazat Abisheva

Discussion

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Overview

Non-linear PRU-CV mortality link in CAD may exist; leaves open whether PRU-guided adjustment improves outcomes.

Key Points

  • Investigate the non-linear association between platelet reactivity and cardiovascular mortality in patients with coronary artery disease.
  • Conducted a retrospective observational cohort study with 1000 patients treated in Kazakhstan
  • Assessed platelet reactivity using the VerifyNow P2Y12 assay
  • Applied multivariable logistic regression and restricted cubic spline regression to analyze data.
  • Linear models showed no independent association between PRU and mortality (OR ~1.00, p > 0.05)
  • Spline analyses indicated a significant U-shaped relationship between PRU and mortality risk (p for non-linearity = X)
  • Both low and high PRU values were linked to increased mortality, while intermediate PRU levels indicated the lowest risk.

Study Design

Type

Cohort (n=1,000)

Multicenter

No

Structured PICO

Is there a non-linear association between platelet reactivity (PRU) and cardiovascular mortality in patients with CAD?

P
Population
1000 patients with angiographically confirmed CAD treated at a tertiary cardiology center in Almaty, Kazakhstan, between 2024 and 2025.
I
Intervention
Platelet reactivity measured as P2Y12 reaction units (PRU) using the VerifyNow P2Y12 assay
O
Outcome
Cardiovascular mortalityhard clinical

Main Result

Effect estimate: OR ~1.00

p-value: p=> 0.05

A U-shaped relationship exists between platelet reactivity and cardiovascular mortality in CAD patients, indicating that both insufficient and excessive platelet inhibition confer increased risk.

Cite This Study

Жангелова et al. (2026) conducted a cohort in Coronary artery disease (n=1,000). Platelet reactivity (PRU) was evaluated on Cardiovascular mortality (OR ~1.00, p=> 0.05). Platelet reactivity (PRU) exhibited a significant U-shaped association with cardiovascular mortality in CAD patients, whereas conventional linear models showed no association (OR ~1.00; p>0.05).

synapsesocial.com/papers/6a1bd1745783ba022b6fd142https://doi.org/10.3390/diseases14060194
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