Profile and prevalence of clopidogrel resistance in patients of acute coronary syndrome.

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dc.contributor.authorKumar, Sandeepen_US
dc.contributor.authorSaran, Ram Ken_US
dc.contributor.authorPuri, Aniketen_US
dc.contributor.authorGupta, Nishanten_US
dc.contributor.authorSethi, Rishien_US
dc.contributor.authorSurin, W Ren_US
dc.contributor.authorDikshit, Madhuen_US
dc.contributor.authorDwivedi, Sudhanshu Ken_US
dc.contributor.authorNarain, Varun Sen_US
dc.contributor.authorPuri, Vijay Ken_US
dc.date.accessioned2007-03-06en_US
dc.date.accessioned2009-05-27T04:28:22Z
dc.date.available2007-03-06en_US
dc.date.available2009-05-27T04:28:22Z
dc.date.issued2007-03-06en_US
dc.description.abstractRecently reports of a variable platelet response to aspirin and potential resistance to therapy have emerged with thienopyridines group of drugs. However the data available on clopidogrel resistance is scarce. The present study was initiated to prospectively evaluate the prevalence of clopidogrel resistance in patients of acute coronary syndrome(ACS) presently on dual anti platelet therapy by using an established method of optical platelet aggregation. We studied 39 patients of ACS, who were on clopidogrel 300 mg bolus followed by 75 mg per day for 3 days along with aspirin 325 mg per day. Fasting blood samples were assessed using optical platelet aggregation (Chronolog Corp, USA). Clopidogrel resistance was defined as <10% decrease from baseline in platelet aggregation. Clopidogrel semi-responders were defined as 10-29% ( <30%) decrease from baseline in platelet aggregation. Clopidogrel non-responders were defined as a composite of resistant and semi-responders. A baseline mean platelet aggregation obtained from 18 healthy subjects was 63.8 +/- 14.75% with 5 mu and 68.8 +/-13.91% with 10 mu of Adenosine Diphosphate. Hence, the definition of clopidogrel resistance was set as aggregation of >57% with 5 mu ADP and >61.9% with 10 mu ADP (< 10% decrease from baseline). The definition of clopidogrel semi-responder was set as aggregation of >or=45% with 5 mu ADP and >or=48% with 10 mu ADP (10-29% decrease from baseline). The mean platelet aggregation with 5 mu and 10 mu of Adenosine Diphosphate in the patient group was 30.77 +/- 17.19% and 35.71 +/- 17.0% respectively. Based on these criteria, 2.54% patients were found to be clopidogrel resistant, 12.7% were clopidogrel semi-responders and 84.7% were clopidogrel responders. On comparison of clopidogrel responders with non-responders, females ( p=0.07) and patients with higher serum triglyceride levels (p=0.08), had a trend to be more inclined towards clopidogrel non-responders. All other parameters tested namely age, smoking, diabetes, hypertension, obesity, cholesterol, hemoglobin, platelet count, ejection fraction and concurrent drug intake did not show any statistically significant difference among the groups. CONCLUSIONS: This study shows that clopidogrel resistant and clopidogrel semi-responders do occur in Indian patients with ACS and there are no reliable clinical predictors for this condition. The diagnosis therefore relies primarily on laboratory tests.en_US
dc.description.affiliationDepartment of Cardiology, King George Medical University, Lucknow.en_US
dc.identifier.citationKumar S, Saran RK, Puri A, Gupta N, Sethi R, Surin WR, Dikshit M, Dwivedi SK, Narain VS, Puri VK. Profile and prevalence of clopidogrel resistance in patients of acute coronary syndrome. Indian Heart Journal. 2007 Mar-Apr; 59(2): 152-6en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/5638
dc.language.isoengen_US
dc.source.urihttps://indianheartjournal.comen_US
dc.subject.meshAcute Coronary Syndrome --drug therapyen_US
dc.subject.meshDrug Resistance --drug effectsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPlatelet Aggregation --drug effectsen_US
dc.subject.meshPlatelet Aggregation Inhibitors --pharmacologyen_US
dc.subject.meshTiclopidine --analogs & derivativesen_US
dc.titleProfile and prevalence of clopidogrel resistance in patients of acute coronary syndrome.en_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
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