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Antiplatelet resistance with aspirin and clopidogrel: is it real and does it matter?

Wai-Hong Chen1

  • 1Department of Medicine, Division of Cardiology, The University of Hong Kong, Room 1929C, Block K, Queen Mary Hospital, Hong Kong, China. whchen@hku.hk

Current Cardiology Reports
|July 11, 2006
PubMed

Insights

Platelet resistance to aspirin and clopidogrel is common, leading to recurrent ischemic events in cardiovascular disease patients. Further research is needed to guide therapy modifications for improved patient outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Hematology

Background:

  • Platelets are crucial in atherosclerotic cardiovascular disease pathophysiology.
  • Aspirin and clopidogrel are standard antiplatelet therapies for atherothrombotic disease.
  • Despite treatment, recurrent ischemic events indicate a need to address treatment variability.

Purpose of the Study:

  • To explore the concept and clinical implications of antiplatelet resistance.
  • To review evidence on interindividual variability in response to oral antiplatelet drugs.
  • To highlight the need for clinical trials on managing antiplatelet resistance.

Main Methods:

  • Review of existing literature on antiplatelet drug responsiveness.
  • Analysis of studies documenting interindividual variability in platelet function.
  • Examination of the association between laboratory resistance and clinical events.

Main Results:

  • Significant interindividual variability in platelet responsiveness to aspirin and clopidogrel exists.
  • Laboratory-defined antiplatelet resistance is linked to adverse clinical outcomes.
  • Prospective trials are needed to validate outcome improvements from resistance-guided therapy.

Conclusions:

  • Antiplatelet resistance is a recognized phenomenon in cardiovascular medicine.
  • Hyporesponsiveness to antiplatelet drugs has clinical consequences.
  • Tailoring antiplatelet therapy based on resistance testing requires further clinical validation.

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