Is a high maintenance dose of clopidogrel suitable for overcoming clopidogrel resistance in patients?

Choi, Ho Rim; Ryu, Ji-Hyeon; Seo, Heenam; Kang, Minku; Kim, Eun Young

doi:10.1007/s11096-015-0118-z

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…The present study showed that, in addition to its antiplatelet effects, clopidogrel showed anti-inflammatory activity; this was evidenced by the decreased serum levels of TNFα, ICAM-1, and RANTES, and heart tissue expression of TNFα, ICAM-1, IL-1β, and RANTES proteins. These findings were consistent with previous studies [22][23][24][25] and indicated that the cardioprotective effects of clopidogrel observed in the present study may be, in part, attributed to these anti-inflammatory effects.…”

Section: Wwwchinapharcom Zhang Y Et Alsupporting

confidence: 94%

Pretreatment with a combination of ligustrazine and berberine improves cardiac function in rats with coronary microembolization

Zhang

Guo

et al. 2016

Acta Pharmacol Sin

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Aim:We have shown that a combination of ligustrazine and berberine produces more effective inhibition on platelet activation and inflammatory reactions in rat acute myocardial infarction compared with either agent alone. In this study we evaluated the beneficial effects of a combination of ligustrazine and berberine in a rat model of coronary microembolization (CME). Methods: SD rats were treated with ligustrazine, berberine, ligustrazine+berberine, or clopidogrel for 2 weeks. When the treatment completed, CME was induced by injection of sodium laurate into the left ventricular, while obstructing the ascending aorta. All rats were intubated for hemodynamic measurements. Blood samples were collected for biochemical analyses, flow cytometry, and ELISAs. Heart tissues were isolated for histopathology and subsequent protein analyses. Results: Pretreatment with the combination of ligustrazine (27 mg·kg -1 ·d -1 ) and berberine (90 mg·kg -1 ·d -1 ) significantly improved cardiac function, and decreased myocardial necrosis, inflammatory cell infiltration, microthrombosis and serum CK-MB levels in CME rats. In addition, this combination significantly decreased plasma ET-1 levels and von Willebrand factor, inhibited ADP-induced platelet activation, and reduced TNFα, IL-1β, ICAM-1 and RANTES levels in serum and heart tissues. The protective effects of this combination were more prominent than those of ligustrazine or berberine alone, but comparable to those of a positive control clopidogrel (6.75 mg·kg -1 ·d -1 ). Conclusion: The combination of ligustrazine and berberine significantly improved cardiac function in rat CME model via a mechanism involving antiplatelet and anti-inflammatory effects.

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Section: Wwwchinapharcom Zhang Y Et Alsupporting

confidence: 94%

Pretreatment with a combination of ligustrazine and berberine improves cardiac function in rats with coronary microembolization

Zhang

Guo

et al. 2016

Acta Pharmacol Sin

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“…Increasing the dose can increase the biological effect of clopidogrel and reduce the incidence of CR. Simultaneously, large doses of clopidogrel can reduce patients' platelet aggregation rate with CR [126]. For PCI patients, the 600 mg loading dose has a faster response than the 300 mg loading dose and has a more substantial platelet inhibitory effect.…”

Section: Increase the Dose Of Clopidogrelmentioning

confidence: 99%

The Role of Genetic Polymorphism and Other Factors on Clopidogrel Resistance (CR) in an Asian Population with Coronary Heart Disease (CHD)

et al. 2021

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Clopidogrel is a widely-used antiplatelet drug. It is important for the treatment and prevention of coronary heart disease. Clopidogrel can effectively reduce platelet activity and therefore reduce stent thrombosis. However, some patients still have ischemic events despite taking the clopidogrel due to the alteration in clopidogrel metabolism attributable to various genetic and non-genetic factors. This review aims to summarise the mechanisms and causes of clopidogrel resistance (CR) and potential strategies to overcome it. This review summarised the possible effects of genetic polymorphism on CR among the Asian population, especially CYP2C19 *2 / *3 / *17, where the prevalence rate among Asians was 23.00%, 4.61%, 15.18%, respectively. The review also studied the effects of other factors and appropriate strategies used to overcome CR. Generally, CR among the Asian population was estimated at 17.2–81.6%. Therefore, our overview provides valuable insight into the causes of RC. In conclusion, understanding the prevalence of drug metabolism-related genetic polymorphism, especially CYP2C19 alleles, will enhance clinical understanding of racial differences in drug reactions, contributing to the development of personalised medicine in Asia.

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Aspirin resistance and other aspirin-related concerns

Cai

Zhou

Ya³

et al. 2015

Neurol Sci

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Aspirin is a widely used medication and has become a cornerstone for treating cardiovascular disease. Aspirin can significantly reduce the incidence of cardiovascular ischemic events, recurrence and mortality, thereby improving the long-term prognosis of patients. However, there has been a staggering increase in the volume of literature addressing the issue of so-called "aspirin resistance" in recent years, and for some patients, it is difficult to avoid adverse reactions to aspirin. In this review, we present both the historical aspects of aspirin use and contemporary developments in its clinical use.

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Is a high maintenance dose of clopidogrel suitable for overcoming clopidogrel resistance in patients?

Abstract: A double maintenance dose of clopidogrel at 150 mg daily was associated with a reduction in adenosine diphosphate-induced platelet aggregation in South Korean patients who previously exhibited clopidogrel resistance.

Cited by 6 publications

References 11 publications

Pretreatment with a combination of ligustrazine and berberine improves cardiac function in rats with coronary microembolization

Pretreatment with a combination of ligustrazine and berberine improves cardiac function in rats with coronary microembolization

The Role of Genetic Polymorphism and Other Factors on Clopidogrel Resistance (CR) in an Asian Population with Coronary Heart Disease (CHD)

Aspirin resistance and other aspirin-related concerns

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