|Clopidogrel response status assessed with Multiplate point-of-care analysis and the incidence and timing of stent thrombosis over six months following coronary stenting.|
|PMID: 20062919 Owner: NLM Status: MEDLINE|
|Clopidogrel low-responsiveness assessed with multiple electrode platelet aggregometry (MEA) has been shown to be a strong and independent predictor of early stent thrombosis (ST) after coronary stenting. The relation of clopidogrel response status, as assessed with MEA, with incidence and timing of ST during an extended follow-up period has never been reported. Here, we report the six-month follow-up results of a prospective trial assessing clopidogrel responsiveness with MEA in patients undergoing percutaneous coronary intervention (PCI). A total of 1,608 consecutive patients with planned drug-eluting stent placement were enrolled in this study. Before PCI patients uniformly received 600 mg clopidogrel and blood was taken directly before PCI to measure ADP-induced platelet aggregation with MEA. The upper quintile (20%) of patients according to MEA measurements (n=323) was defined as clopidogrel low responders. Compared with normal responders (n=1,285), the cumulative incidence of definite ST within six months was significantly higher in low responders [2.5% vs. 0.4%; OR 6.5; 95% CI, 2.4-17.0; P<0.001]. The combined incidence of definite or probable ST was higher as well in low vs. normal responders [4.1% vs. 0.7%; OR 5.8; 95% CI, 2.8-12.3; P<0.0001]. A significant inverse correlation of MEA values and the timing of definite or probable ST (in days) was observed (Spearman coefficient = -0.45; P=0.04) with events occurring earlier in the low-responder group. MEA measurements are highly predictive for the occurrence of ST during the first six months following coronary stenting. In the majority of clopidogrel low responders suffering ST, the ischaemic event occurs early in the course after the procedure.|
|Dirk Sibbing; Tanja Morath; Siegmund Braun; Julia Stegherr; Julinda Mehilli; Wolfgang Vogt; Albert Sch?mig; Adnan Kastrati; Nicolas von Beckerath|
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|Type: Clinical Trial; Journal Article; Multicenter Study Date: 2009-10-26|
|Title: Thrombosis and haemostasis Volume: 103 ISSN: 0340-6245 ISO Abbreviation: Thromb. Haemost. Publication Date: 2010 Jan|
|Created Date: 2010-01-11 Completed Date: 2010-03-30 Revised Date: -|
Medline Journal Info:
|Nlm Unique ID: 7608063 Medline TA: Thromb Haemost Country: Germany|
|Languages: eng Pagination: 151-9 Citation Subset: IM|
|Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar, Lazarettstrasse 36, 80636 M?nchen, Germany. firstname.lastname@example.org|
|APA/MLA Format Download EndNote Download BibTex|
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects, instrumentation*, mortality
Blood Coagulation Tests*
Drug Monitoring / methods*
Platelet Aggregation / drug effects*
Platelet Aggregation Inhibitors / therapeutic use*
Predictive Value of Tests
Proportional Hazards Models
Thrombosis / diagnosis*, etiology, mortality, prevention & control
Ticlopidine / analogs & derivatives*, therapeutic use
|0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; 58-64-0/Adenosine Diphosphate; 90055-48-4/clopidogrel|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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