Document Detail


Platelet aggregation according to body mass index in patients undergoing coronary stenting: should clopidogrel loading-dose be weight adjusted?
MedLine Citation:
PMID:  15152138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A 300 mg clopidogrel loading-dose (LD) is widely used as an adjunct antithrombotic treatment to reduce the risk of thrombotic events early after coronary stenting (CS). Antithrombotic drugs commonly used during percutaneous coronary interventions, such as heparin and platelet glycoprotein IIb/IIIa inhibitors, but not clopidogrel LD, are weight-adjusted, and few data are available on which is the most effective clopidogrel LD regimen. The aim of this study was to assess whether body mass index (BMI) influenced platelet response to clopidogrel LD in patients undergoing CS. METHODS: Adenosine diphosphate (ADP)-induced platelet aggregation (PA) was assessed by light transmittance aggregometry in 48 patients on aspirin treatment undergoing CS receiving a 300 mg clopidogrel LD at intervention time. PA was assessed at baseline and up to 24 hours after intervention. Patients were divided into 2 groups according to BMI: overweight (BMI greater than or equal to 25 kg/m2; 29 patients) and normal weight (BMI<25 kg/m2; 19 patients). PA was significantly higher in overweight than in normal weight patients at baseline (60.1+/-18.6%; versus 47.6+/-13.5%; p=0.01), at 24 hours (42.3+/-18.4% versus 38.5+/-18.3%; p=0.02) and during the overall study time (p=0.025). Percentage of inhibition of PA 24 hours following clopidogrel LD was suboptimal (<40%) in 59% and 26% of overweight and normal weight patients, respectively (p=0.04). An elevated BMI was the only independent predictor of suboptimal platelet response. CONCLUSION: These data suggest that overweight patients may need a higher loading-dose of clopidogrel and/or an adjunct antithrombotic treatment to adequately inhibit platelet aggregation early after CS.
Authors:
Dominick J Angiolillo; Antonio Fernández-Ortiz; Esther Bernardo; Carlos Barrera Ramírez; Manel Sabaté; Cristina Fernandez; Rosana Hernández-Antolín; Javier Escaned; Fernando Alfonso; Carlos Macaya
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  16     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-05-20     Completed Date:  2004-11-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  169-74     Citation Subset:  IM    
Affiliation:
Interventional Cardiology Unit-Cardiovascular Institute, San Carlos University Hospital, Plaza Cristo Rey s-n-planta 2N, 28040 Madrid, Spain. dominickjangiolillo@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Vessel Prosthesis Implantation
Body Mass Index*
Body Weight / physiology
Coronary Stenosis / physiopathology*,  therapy*
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Male
Middle Aged
Platelet Aggregation / drug effects*
Platelet Aggregation Inhibitors / administration & dosage
Spain
Stents*
Ticlopidine / administration & dosage,  analogs & derivatives*
Treatment Outcome
Weights and Measures
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel
Comments/Corrections
Comment In:
J Invasive Cardiol. 2004 Apr;16(4):175-6   [PMID:  15152139 ]

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


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