Purpose
Antiplate
let drugs, including aspirin and clopidogrel have proven efficacy in atherothrombotic event prevention. However, variability of plate
let response measured in the laboratory has been reported and is a subject of keen interest.
Methods
500 consecutive Pts treated with PCI between Nov 2007 and Dec 2009 and who had VASP and PFA tests performed were retrospectively identified from a dedicated database. All Pts were pretreated with a loading dose of 600 mg clopidogrel and had a daily maintenance dose of 75 mg, or 150 mg if their weight was > 80 kg. All Pts were under regular aspirin (160 mg/day). Using VASP >50 % and PFA<170 to define aspirin and clopidogrel resistance, we compared Pts who were double non-responders with double responders.
Results
246 (49.2 % ) patients were responders to both aspirin and clopidogrel, while 58 (11.6 % ) were double non-responders. Multivariate analysis confirmed statistical significance between hypertensive Pts and double responders (p = 0.03) and a higher rate of males (p = 0.06) as well as pts with previous myocardial infarction (p = 0.06) in this group. There were no statistically significant differences in sex, BMI or diabetics.le class=""dataTable"" frame=""hsides"" border=""0"" cellpadding=""0"" rules=""groups"" cellspacing=""0"">left"">Variable | Double responders | Double non-responders | P |
---|
left"">Male | 191 (77.6 % ) | 50 (86.2 % ) | 0.15 |
left"">Age (yrs) | 67.3+/-10.6 | 63.8+/-11.5 | 0.06 |
left"">Weight (kg) | 77.7+/-15.3 | 79.2+/-14.6 | 0.48 |
left"">BMI | 25.4+/-7.2 | 27.2+/-5.4 | 0.04 |
left"">Smoking | 89 (36.2 % ) | 20 (35.5 % ) | 0.81 |
left"">Dyslipidaemia | 152 (61.8 % ) | 35 (61.4 % ) | 0.96 |
left"">Diabetes | 52 (4.7 % ) | 17 (6.1 % ) | 0.22 |
left"">Hypertension | 159 (64.6 % ) | 29 (50.1 % ) | 0.06 |
left"">Family history | 18 (7.3 % ) | 2 (3.5 % ) | 0.20 |
left"">Past PCI | 88 (35.8 % ) | 19 (33.3 % ) | 0.73 |
left"">Past CABG | 9 (3.7 % ) | 2 (3.5 % ) | 0.96 |
left"">Past MI | 25 (10.1 % ) | 11 (19.2 % ) | 0.11 |
left"">Weight <75 kg | 116 (46.8 % ) | 18 (31.0 % ) | 0.02 |
le>