The clopidogrel resistance can be attenuated with triple antiplatelet therapy in patients undergoing drug-eluting stents implantation

Shim, Chi Young; Yoon, Sang-Wook; Park, Sungha; Kim, Jung Sun; Choi, Jong Rak; Ko, Young Guk; Choi, Donghoon; Ha, Jong Won; Jang, Yangsoo; Chung, Namsik; Shim, Won Heum; Cho, Seung Yun

doi:10.1016/j.ijcard.2008.02.016

Cited by 43 publications

(38 citation statements)

References 25 publications

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“…23 Recent studies support the role of adequate platelet inhibition by demonstrating better outcome in patients treated with new and more potent antiplatelet therapies. 24 Our results are in accordance with previous reports regarding the clinical importance of measuring RPR after clopidogrel loading. 12 In addition, the concept of inadequate platelet inhibition by clopidogrel should be considered for risk-stratification after STEMI, especially in patients prone to arterial and stent thrombosis, such as those with diabetes mellitus.…”

Section: Discussionsupporting

confidence: 93%

Residual Platelet Reactivity After Clopidogrel Loading in Patients With ST-Elevation Myocardial Infarction Undergoing an Unexpectedly Delayed Primary Percutaneous Coronary Intervention - Impact on Intracoronary Thrombus Burden and Myocardial Perfusion -

Vavuranakis

Vrachatis

Papaioannou

et al. 2011

Circ J

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Section: Discussionsupporting

confidence: 93%

Residual Platelet Reactivity After Clopidogrel Loading in Patients With ST-Elevation Myocardial Infarction Undergoing an Unexpectedly Delayed Primary Percutaneous Coronary Intervention - Impact on Intracoronary Thrombus Burden and Myocardial Perfusion -

Vavuranakis

Vrachatis

Papaioannou

et al. 2011

Circ J

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“…This finding is consistent with those in previous reports. 18,19 More recent reports from the cardiovascular literature suggest using a threshold based on PRU. 27 It is important to distinguish between a cardiovascular and neurovascular patient population for 1 major reason: risk of hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…Clopidogrel resistance was defined as percentage platelet inhibition Յ20%, consistent with that in previous studies. 18,19 Patients were classified as resistant if testing showed the above-defined levels after 5 days of treatment or a loading dose was given.…”

Section: Platelet Function Testingmentioning

confidence: 99%

Clopidogrel Resistance Is Associated with Thromboembolic Complications in Patients Undergoing Neurovascular Stenting

Fifi¹,

Brockington²,

Narang

et al. 2012

AJNR Am J Neuroradiol

137

101

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“…PCI restenosis is a major problem for physicians and patients, and it is not good for each patient to strengthen antiplatelet therapy. Several clinical studies in Japan and South Korea have suggested that clopidogrel has no response or has a low response rate of 4-40% (11,12). Furthermore, in some studies (13), the definition of "aspirin resistance" and "clopidogrel resistance" is similar to "antiplatelet drug resistance".…”

Section: Discussionmentioning

confidence: 99%

The application of thromboelastogram in detection of indexes of antiplatelet therapy for coronary heart disease

Shuwu¹,

Wang²,

Xu³

et al. 2016

J. Thorac. Dis.

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Background: This study aims to explore the application value of thromboelastogram (TEG) in antiplatelet therapy in coronary artery intervention.Methods: A retrospective analysis of 90 cases of coronary interventional treatment was conducted in our hospital from January 2010 to January 2012. Cases were divided into three groups, according to the kind of coronary heart disease: angina pectoris (AP) group (30 cases), unstable angina pectoris (UAP) group (30 cases) and acute myocardial infarction (AMI) group (30 cases). TEG changes in patients between the three groups were analyzed.Results: The differences in international normalized ratio (INR) and activated partial thromboplastin time (APTT) indexes among the three groups of patients were statistically significant (P<0.05), but these indexes significantly decreased in the AMI group. Furthermore, D-D, Fgb, Angle and MA indexes significantly increased in the UAP and AMI groups, compared with the AP group; while TEG regular parameter K and R values were markedly reduced. Coagulation graphics were higher in the UAP and AMI groups than in the AP group (χ 2 =4.261, 3.908; P<0.05), suggesting that the difference was statistically significant. In 11 cases of ischemic events, arachidonic acid (AA)-induced platelet inhibition rate was 63.63%, while adenosine diphosphate (ADP)-induced platelet inhibition rate was 36.37% (χ 2 =5.026; P<0.05); suggesting that ADP-induced platelet inhibition rate was markedly reduced. This is the main risk of ischemic events within three months after percutaneous coronary intervention. Conclusions:The detection of indexes of antiplatelet therapy in coronary artery intervention is helpful for antiplatelet medication, thus can effectively reduce the incidence of ischemic events.

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The clopidogrel resistance can be attenuated with triple antiplatelet therapy in patients undergoing drug-eluting stents implantation

Cited by 43 publications

References 25 publications

Residual Platelet Reactivity After Clopidogrel Loading in Patients With ST-Elevation Myocardial Infarction Undergoing an Unexpectedly Delayed Primary Percutaneous Coronary Intervention - Impact on Intracoronary Thrombus Burden and Myocardial Perfusion -

Residual Platelet Reactivity After Clopidogrel Loading in Patients With ST-Elevation Myocardial Infarction Undergoing an Unexpectedly Delayed Primary Percutaneous Coronary Intervention - Impact on Intracoronary Thrombus Burden and Myocardial Perfusion -

Clopidogrel Resistance Is Associated with Thromboembolic Complications in Patients Undergoing Neurovascular Stenting

The application of thromboelastogram in detection of indexes of antiplatelet therapy for coronary heart disease

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