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Resistance to antiplatelet therapy
Sasidhar Guthikonda1, Eli I Lev, Neal S Kleiman
1Baylor College of Medicine, 6565 Fannin, MS F1090, Houston, TX 77030, USA.
Current Cardiology Reports
|July 1, 2005
Summary
High cardiovascular events occur despite antiplatelet drugs like aspirin and clopidogrel. Patient resistance to these drugs, termed aspirin resistance and clopidogrel resistance, is common and requires further research.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Cardiovascular mortality remains high in patients using antiplatelet medications.
- Aspirin and clopidogrel are standard treatments for coronary artery disease and post-percutaneous angioplasty.
- Patient response to aspirin and clopidogrel is variable, leading to resistance.
Purpose of the Study:
- To highlight the clinical significance of aspirin resistance and clopidogrel resistance.
- To explore the postulated mechanisms behind these resistance phenomena.
- To identify the need for further research into testing and treatment strategies.
Main Methods:
- Review of existing literature on antiplatelet therapy and resistance.
- Discussion of potential genetic, pharmacokinetic, and platelet property alterations.
- Identification of knowledge gaps in clinical significance, testing, and treatment.
Main Results:
- Diminished or absent platelet response to aspirin and clopidogrel, termed resistance, affects over 50% of patients.
- Mechanisms of resistance may involve genetic, pharmacokinetic, and platelet factors.
- Limited information exists regarding the clinical impact and management of resistance.
Conclusions:
- Aspirin and clopidogrel resistance are significant clinical issues with high prevalence.
- Further research is crucial to understand the clinical significance, develop diagnostic methods, and establish effective treatment strategies.
- Identifying and managing patients with resistance is essential for improving cardiovascular outcomes.
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