Grdinic A, Vojvodic D, Djukanovic N, Colic M, Grdinic AG, Ignjatovic V, Majstorovic I, Ilic V, Magic Z, Obradovic S, Ostojic M, Dolijanovic SP. PCI and clopidogrel: antiplatelet responsiveness and patient characteristics.
Acta Cardiol 2011;
66:333-40. [PMID:
21744703 DOI:
10.2143/ac.66.3.2114133]
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Abstract
OBJECTIVE
This study on responsiveness to clopidogrel and aspirin evaluates its interaction with: (i) patient characteristics; (ii) procedure characteristics; (iii) antiplatelet dose.
METHODS AND RESULTS
After elective PCI, 60 patients receiving aspirin 100 mg daily, and clopidogrel 75 mg daily were monitored with the PFA 100 test and VASP assay. Non-responsiveness to aspirin and clopidogrel was found in 23 (38%) and 18 (30%) of 60 patients, respectively. Seven (12%) patients were dual nonresponders. Non-responders to both aspirin and clopidogrel were more often smokers. Non-responders to clopidogrel, in addition had elevated inflammatory markers (P < 0.05). Dual non-responders had (i) a higher platelet count, LDL, and CRP; (ii) a lower HDL (P < 0.05). Clopidogrel non-responders were receiving 150 mg clopidogrel, with a positive response in 72%. Eighty % of non-responders to 150 mg clopidogrel were also non-responders to aspirin.
CONCLUSION
Baseline patient characteristics and clopidogrel dose modify the antiplatelet response. Also, patients resistant to both aspirin and clopidogrel do no benefit from an increased clopidogrel dose.
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