Abstract | BACKGROUND: Numerous reports have dichotomized responses after clopidogrel therapy using varying definitions and platelet tests in patients immediately after acute vascular events; however, no large study has assessed platelet characteristics in outpatients receiving long-term treatment for more than 30 days with the maintenance dose (75 mg/d) of clopidogrel. The aim of this study was to describe the responses of ex vivo measures of platelet aggregation and activation to long-term clopidogrel therapy in a large population of outpatients after coronary stenting or ischemic stroke. METHODS: We conducted a secondary post hoc analysis of a data set represented by presumably compliant patients after coronary stenting (n = 237) or a documented ischemic stroke (n = 122) treated with clopidogrel-and- aspirin combination antiplatelet therapy. RESULTS: CONCLUSIONS: In contrast to the wide variability of responses that exists in the acute setting, long-term therapy with clopidogrel leads to consistent and much less variable platelet inhibition. Lack of nonresponse and profound inhibition with clopidogrel allow for the maintenance of a delicate balance between proven efficacy and acceptable bleeding risks for long-term secondary prevention in outpatients after acute vascular events.
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Authors | Victor L Serebruany, Alex I Malinin, Dan Atar, Dan F Hanley |
Journal | American heart journal
(Am Heart J)
Vol. 153
Issue 3
Pg. 371-7
(Mar 2007)
ISSN: 1097-6744 [Electronic] United States |
PMID | 17307414
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Inflammatory Agents, Non-Steroidal
- Integrin beta3
- Platelet Aggregation Inhibitors
- Platelet Endothelial Cell Adhesion Molecule-1
- Platelet Membrane Glycoprotein IIb
- Clopidogrel
- Ticlopidine
- Aspirin
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Topics |
- Aged
- Anti-Inflammatory Agents, Non-Steroidal
(therapeutic use)
- Aspirin
(therapeutic use)
- Clopidogrel
- Drug Therapy, Combination
- Female
- Flow Cytometry
- Humans
- Integrin beta3
(blood)
- Male
- Middle Aged
- Patient Compliance
- Platelet Aggregation Inhibitors
(administration & dosage)
- Platelet Endothelial Cell Adhesion Molecule-1
(blood)
- Platelet Function Tests
- Platelet Membrane Glycoprotein IIb
(blood)
- Risk Factors
- Ticlopidine
(administration & dosage, analogs & derivatives)
- Vascular Diseases
(drug therapy, epidemiology, physiopathology)
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