Aspirin and clopidogrel resistance using the cone and plate(let) analyser in Indian patients with coronary artery disease

Abstract

Background Resistance to antiplatelet drugs is a wellknown entity. However, data for aspirin and clopidogrel resistance, and its clinical significance, in Indian patients are meagre. Aims and objectives We sought to determine the prevalence of resistance to aspirin and clopidogrel in Indian patients with stable coronary heart disease (CHD), using the cone and plate(let) analyser (CPA) technology. Setting and design A single centre prospective study in a cohort of patients with stable CHD on chronic aspirin and clopidogrel therapy attending the cardiology outpatient clinic of a tertiary care hospital in Southern India. Methods Platelet function was measured using the Impact-R device (DiaMed, Cressier, Switzerland). Resistance to aspirin and clopidogrel was measured in a cohort of 100 patients with stable documented CHD. Relation of antiplatelet resistance to various clinical comorbidities was also assessed. Results Of the 100 patients, 85% were men, and 15% were above 65 years of age. 47% patients had diabetes, 29% of patients were hypertensive and 16% were smokers. Using the CPA, 12 patients (12%) were found to be resistant to aspirin and 19 patients (19%) were clopidogrel resistant. In addition, 10 patients (10%) were resistant to both aspirin and clopidogrel. There was no significant correlation between the presence of antiplatelet resistance and several baseline clinical variables, including age, sex, diabetes, hypertension and smoking. Conclusions Resistance to aspirin and clopidogrel and dual antiplatelet resistance are prevalent in Indian patients, comparable with the prevalence worldwide. The CPA is a feasible assay to determine antiplatelet resistance.

Platelets: From Formation to Function

“…WBCs. The addition of platelet agonists such as arachidonic acid (AA) and ADP in the system has enabled the evaluation of dual anti-platelet therapy [87][88][89]. The system is effective in the assessment of platelet function disorders in adults, [90] children [91] and new-borns [92].…”

Comparison of Light Transmission Aggregometry and VerifyNow in Detecting Clopidogrel Resistance and Factors Affecting Clopidogrel Resistance in AMI-EST Patients Undergoing Percutaneous Coronary Intervention: A Cross-Sectional Study

“…(6) The results of other studies regarding the relationship between individual factors and the occurrence of clopidogrel resistance were various. (8) Several tests are available to measure platelet function and the effect of antiplatelets. (4) Light transmission aggregometry (LTA) is recognized as the gold standard for examining platelet function.…”