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

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• 作者：Anouska Moynagh¹ ; Pankaj Jariwala¹ ; Thomas Hovasse¹ ; Marie-Claude Morice¹ ; Yves Louvard¹ ; Thierry Unterseeh² ; Hakim Benamer¹ ; Bernard Chevalier¹ ; Philippe Garot¹ ; Thierry Lefè ; vre¹
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2011
• 出版时间：January 2011
• 年：2011
• 卷：3
• 期：1
• 页码：23-24
• 全文大小：52 K

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.

Variable	Double responders	Double non-responders	P
Male	191 (77.6 % )	50 (86.2 % )	0.15
Age (yrs)	67.3+/-10.6	63.8+/-11.5	0.06
Weight (kg)	77.7+/-15.3	79.2+/-14.6	0.48
BMI	25.4+/-7.2	27.2+/-5.4	0.04
Smoking	89 (36.2 % )	20 (35.5 % )	0.81
Dyslipidaemia	152 (61.8 % )	35 (61.4 % )	0.96
Diabetes	52 (4.7 % )	17 (6.1 % )	0.22
Hypertension	159 (64.6 % )	29 (50.1 % )	0.06
Family history	18 (7.3 % )	2 (3.5 % )	0.20
Past PCI	88 (35.8 % )	19 (33.3 % )	0.73
Past CABG	9 (3.7 % )	2 (3.5 % )	0.96
Past MI	25 (10.1 % )	11 (19.2 % )	0.11
Weight <75 kg	116 (46.8 % )	18 (31.0 % )	0.02