Document Detail


Determination of the prevalence of aspirin and clopidogrel resistances in patients with coronary artery disease by using various platelet-function tests.
MedLine Citation:
PMID:  20890076     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dual therapy with aspirin and clopidogrel has emerged as the gold standard therapy for patients treated with drug-eluting stents (DES). However, there is variability in patients' responses to this antiplatelet therapy, and some patients continue to show ischemic recurrences after therapy. The purpose of the study was to compare the simultaneously obtained results of various platelet-function tests for assessing the prevalence of antiplatelet resistance in coronary artery disease patients undergoing DES therapy.
METHODS: A total of 66 patients were administered a loading dose of aspirin, clopidogrel, and cilostazol at least 12 hr before stenting. The results of VerifyNow (Accumetrics, USA), multiplate analyzer (Dynabyte Medical, Germany), and vasodilator-stimulated phosphoprotein/P2Y12 (Biocytex, France) assays were compared with those of light transmission aggregometry (LTA) analysis.
RESULTS: The P2Y12 reaction units and P2Y12% inhibition values obtained using the VerifyNow assay showed strong correlation (r) with the results of the LTA analysis. All tests results showed low concordance in defining the antiplatelet resistance in patients, and the degrees of agreement were as follows: 0 for aspirin reaction units; 0.25, P2Y12% inhibition; 0, aspirin-sensitive patients' identification test; 0.21, ADPtest; and 0.14, platelet reactivity index, expressed as the κ statistics. The prevalence of aspirin and clopidogrel resistances in patients resulted in remarkable variations, from 0% to 22.7% and from 9.1% to 48.5%, respectively.
CONCLUSIONS: The clinical usefulness of the different assays for the correct classification of patients in terms of antiplatelet resistance remains unclear. Further studies are required to determine the best method for correlating the occurrences of adverse ischemic events.
Authors:
Kwang-Sook Woo; Bo-Ram Kim; Ji-Eun Kim; Ri-Young Goh; Long-Hao Yu; Moo-Hyun Kim; Jin-Yeong Han
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Korean journal of laboratory medicine     Volume:  30     ISSN:  1598-6535     ISO Abbreviation:  Korean J Lab Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-02-17     Revised Date:  2014-05-30    
Medline Journal Info:
Nlm Unique ID:  101322822     Medline TA:  Korean J Lab Med     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  460-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aspirin / administration & dosage*
Coronary Artery Disease / drug therapy*
Drug Resistance
Drug Therapy, Combination
Drug-Eluting Stents
Female
Humans
Male
Middle Aged
Platelet Aggregation / drug effects
Platelet Aggregation Inhibitors / administration & dosage*
Platelet Function Tests
Purinergic P2Y Receptor Antagonists / administration & dosage
Receptors, Purinergic P2Y12 / metabolism
Tetrazoles / administration & dosage
Ticlopidine / administration & dosage,  analogs & derivatives*
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 0/Purinergic P2Y Receptor Antagonists; 0/Receptors, Purinergic P2Y12; 0/Tetrazoles; A74586SNO7/clopidogrel; N7Z035406B/cilostazol; OM90ZUW7M1/Ticlopidine; R16CO5Y76E/Aspirin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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