Frequency of Clopidogrel Resistance in Patients of Ischemic Heart Disease

Abstract

Clopidogrel and Aspirin are widely used antiplatelet agents in the prevention and treatment of isch- emic heart disease (IHD). Many patients have been noticed with recurrence of major ischemic events, due to resistance of these drugs. Different platelet function tests can be used to evaluate the de- gree of achieved platelet inhibition in patients treated with clopidogrel. The objective of this study was to determine frequency of clopidogrel resistance in patients of ischemic heart disease. Seventy one patients of IHD were selected from out-patient department of Punjab Institute of Cardiology Lahore. Platelet aggregation studies were performed on Diamed Impact R. Clopidogrel response as- say was performed with DiaAdin(ADP 110μmol/L). Chi-square test was applied to measure statistical significance. Resistance to Clopidogrel was observed in 17% (12 out of 71). Clopidogrel resistance was significantly associated with female gender (p=0.046). In our study no statistically significant as- sociation was observed between clopidogrel resistance and risk factors like diabetes mellitus, family history ischemic heart disease, hypertension and smoking. We concluded that resistance to Clopido- grel therapy is seen in significant number of patients and female patients are at high risk of develop- ing the resistance to clopidogrel therapy. These patients can be identified by performing platelet aggregation studies on Impact R

Efecto de la hiperglucemia en el síndrome coronario agudo y sus implicaciones en el tratamiento antiagregante plaquetario

“…El tratamiento del SCA se fundamenta en reestablecer la circulación coronaria, ya sea por medios mecánicos (intervención coronaria percutánea (ICP), derivación coronaria) o farmacológicos (trombolisis), así como en impactar sobre las diversas vías fisiopatológicas implicadas en la génesis y progresión del SCA; la terapia dual antiagregante plaquetaria (ácido acetil salicílico sumado a un inhibidor del P2Y12, siendo el clopidogrel el más usado) es el pilar del tratamiento, tanto en la fase aguda como en la crónica (33,(47)(48)(49).…”