The treatment of clopidogrel resistance: Triple antiplatelet therapy and future directions

Açıkel, Sadık; Akdemir, Ramazan; Çağırcı, Göksel; Yeşilay, Asuman Biçer; Doğan, Mehmet; Kılıç, Harun

doi:10.1016/j.ijcard.2008.12.030

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…Some researchers declared that this situation may be related to clopidogrel resistance or high on-treatment platelet reactivity, and evidence showed that older patients were more likely to be having high on-treatment platelet reactivity and resistance to clopidogrel [12, 13]. For those with low clopidogrel response, clopidogrel was for the most part overdosed, which appeared to be ineffective in branch atherosclerotic diseases [14, 15] or was switched to other drugs such as prasugrel or ticagrelor or used in combination with other medications [16, 17]. Research illustrated that clopidogrel combined with aspirin caused a lower recurrence rate of coronary artery disease in the first year after coronary artery bypass grafting compared to the addition of aspirin to placebo, despite aspirin and clopidogrel as classic antiplatelet drugs commonly used in combination for CHD patients [18, 19].…”

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confidence: 99%

A Review of Danshen Combined with Clopidogrel in the Treatment of Coronary Heart Disease

Zhang

Wang

Tan

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Objective. Danshen, the root of Salvia miltiorrhiza Bunge, is a traditional herbal medicine in China, which has been used to treat irregular menstruation, cold hernia, and abdominal pain for thousands of years. Danshen is frequently used in combination with drugs to treat cardiovascular diseases. Clopidogrel is a commonly used drug for treating coronary heart disease, but clopidogrel resistance restricts its development. Therefore, the clinical efficacy of Danshen combined with clopidogrel treats coronary heart disease and the relationship between Danshen and clopidogrel metabolism enzymes is suggested for future investigations. Materials and Methods. The information was collected by searching online databases, and the RevMan 5.3 software was used to perform meta-analysis. Results. Twenty-two articles, including 2587 patients, were enrolled after the evaluation. Meta-analysis showed that Danshen combined with clopidogrel was more effective than clopidogrel alone in treating coronary heart disease by improving clinical curative effect, reducing the frequency of angina pectoris, improving electrocardiogram results, shortening the duration of angina pectoris, and easing adverse reactions. Danshen inhibited carboxylesterase 1 and most enzyme of cytochrome P450, especially cytochrome P450 1A2, which may affect the metabolism of clopidogrel. Conclusion. Danshen combined with clopidogrel may compensate for individual differences of clopidogrel resistance among individuals in the treatment of coronary heart disease. Meanwhile, the inhibitory effect of Danshen on cytochrome P450 and carboxylesterase 1 could be partly responsible for the synergistic and attenuating effects of Danshen combined with clopidogrel.

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Section: Introductionmentioning

confidence: 99%

A Review of Danshen Combined with Clopidogrel in the Treatment of Coronary Heart Disease

Zhang

Wang

Tan

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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ST-Segment Elevation Myocardial Infarction

Antman¹,

Morrow²

2012

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine

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The Relationship Between Inflammation, Platelet Activation and Antiplatelet Resistance

Açıkel

Akdemir²

2010

IADT

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Even though there is a strong evidence suggestive of benefits and safety of dual (aspirin plus clopidogrel) antiplatelet therapy, decreased responsiveness or "resistance" to mono- and/or dual antiplatelet therapy has been described in association with an increased thrombotic risk. Various mechanisms contribute to antiplatelet resistance, with abundant production of inflammatory markers being of particular importance. The current review overviews implications of inflammation in antiplatelet resistance.

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The treatment of clopidogrel resistance: Triple antiplatelet therapy and future directions

Cited by 3 publications

References 29 publications

A Review of Danshen Combined with Clopidogrel in the Treatment of Coronary Heart Disease

A Review of Danshen Combined with Clopidogrel in the Treatment of Coronary Heart Disease

ST-Segment Elevation Myocardial Infarction

The Relationship Between Inflammation, Platelet Activation and Antiplatelet Resistance

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