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073 Does clinical profile predict double non-responsiveness to aspirin and clopidogrel?
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文摘

Purpose

Antiplatelet drugs, including aspirin and clopidogrel have proven efficacy in atherothrombotic event prevention. However, variability of platelet 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"">VariableDouble respondersDouble non-respondersP
left"">Male191 (77.6 % )50 (86.2 % )0.15
left"">Age (yrs)67.3+/-10.663.8+/-11.50.06
left"">Weight (kg)77.7+/-15.379.2+/-14.60.48
left"">BMI25.4+/-7.227.2+/-5.40.04
left"">Smoking89 (36.2 % )20 (35.5 % )0.81
left"">Dyslipidaemia152 (61.8 % )35 (61.4 % )0.96
left"">Diabetes52 (4.7 % )17 (6.1 % )0.22
left"">Hypertension159 (64.6 % )29 (50.1 % )0.06
left"">Family history18 (7.3 % )2 (3.5 % )0.20
left"">Past PCI88 (35.8 % )19 (33.3 % )0.73
left"">Past CABG9 (3.7 % )2 (3.5 % )0.96
left"">Past MI25 (10.1 % )11 (19.2 % )0.11
left"">Weight <75 kg116 (46.8 % )18 (31.0 % )0.02
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