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Clopidogrel resistance: myth or reality?

Aron A Barsky1, Rohit R Arora

  • 1Division of Cardiovascular Disease, Department of Medicine, Chicago Medical School, Chicago, IL 60604, USA.

Journal of Cardiovascular Pharmacology and Therapeutics
|May 17, 2006
PubMed
Summary

Dual antiplatelet therapy is crucial for preventing cardiovascular events. However, some patients exhibit clopidogrel resistance, impacting treatment effectiveness and clinical outcomes, necessitating further research.

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Platelets are key in arterial thrombosis and cardiovascular events.
  • Antiplatelet therapy, particularly dual therapy with aspirin and clopidogrel, is standard for secondary prevention and post-percutaneous coronary intervention.
  • Subacute stent thrombosis persists in 1-2% of patients despite dual antiplatelet therapy.

Purpose of the Study:

  • To review the origins and definition challenges of clopidogrel resistance.
  • To discuss the clinical implications and future challenges of clopidogrel resistance.

Main Methods:

  • Literature review focusing on studies investigating clopidogrel response and resistance.
  • Analysis of existing definitions and proposed mechanisms of clopidogrel resistance.

Main Results:

  • Interindividual variations in response to clopidogrel exist, leading to resistance in a subset of patients.
  • Clopidogrel resistance is linked to adverse clinical outcomes, including stent thrombosis.
  • A universally accepted definition and understanding of clopidogrel resistance mechanisms are currently lacking.

Conclusions:

  • Clopidogrel resistance poses a significant clinical challenge due to its variable definition and unclear mechanisms.
  • Further research is needed to standardize the definition and elucidate the mechanisms of clopidogrel resistance to optimize patient care.

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