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

Authors
 Chi Young Shim  ;  Se-Jung Yoon  ;  Sungha Park  ;  Jung-Sun Kim  ;  Jong Rak Choi  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Jong-Won Ha  ;  Yangsoo Jang  ;  Namsik Chung  ;  Won-Heum Shim  ;  Seung-Yun Cho 
Citation
 INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.134(3) : 351-355, 2009 
Journal Title
INTERNATIONAL JOURNAL OF CARDIOLOGY
ISSN
 0167-5273 
Issue Date
2009
MeSH
Aged ; Cardiovascular Surgical Procedures/adverse effects ; Cardiovascular Surgical Procedures/instrumentation* ; Drug Resistance/drug effects ; Drug Resistance/physiology* ; Drug Therapy, Combination ; Drug-Eluting Stents/adverse effects* ; Female ; Humans ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/administration & dosage* ; Postoperative Complications/drug therapy ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Thrombosis/drug therapy ; Thrombosis/etiology ; Thrombosis/prevention & control ; Ticlopidine/administration & dosage ; Ticlopidine/analogs & derivatives*
Abstract
BACKGROUND: Triple antiplatelet therapy may have a beneficial effect on prevention of thrombotic complication in patients undergoing coronary stenting. We investigated the prevalence of aspirin and clopidogrel resistance in patients treated with dual and triple antiplatelet regimen after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).

METHODS: A total of 400 consecutive patients underwent successful PCI with DES were randomly assigned to therapy with dual antiplatelet regimens (aspirin plus clopidogrel, Group I, n = 200) and triple antiplatelet regimens (aspirin plus clopidogrel plus cilostazol, Group II, n = 200) At two weeks after PCI, aspirin and clopidogrel resistance were assayed in 379 patients (Group I, n = 186; Group II, n = 193) by using the VerifyNow System.

RESULTS: In Group I, 21 (11.3%) patients had aspirin resistance and 74 (40.0%) had clopidogrel resistance. In Group II, 19 (9.8%) were resistant to aspirin and 38 (19.7%) to clopidogrel. The aspirin reaction unit (ARU) was not significantly different between groups (448+/-67 vs. 439+/-64, P = 0.200), but the percent inhibition of clopidogrel was higher in Group II (41.4+/-24.3%,) comparing with that of Group I (26.5+/-18.7%, P < 0.001).

CONCLUSION: With triple antiplatelet therapy, the prevalence of clopidogrel resistance can be attenuated in patients undergoing PCI with DES
Full Text
http://www.sciencedirect.com/science/article/pii/S0167527308004488
DOI
10.1016/j.ijcard.2008.02.016
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Shim, Won Heum(심원흠)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Yoon, Se Jung(윤세정)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Cho, Seung Yun(조승연)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Choi, Jong Rak(최종락) ORCID logo https://orcid.org/0000-0002-0608-2989
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103793
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