Significance of aspirin and clopidogrel resistance in patients undergoing percutaneous coronary interventions

Area of Science:

• Cardiology
• Pharmacology
• Interventional Cardiology

Background:

• Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is standard after coronary stent implantation.
• Despite DAPT, a significant number of patients experience recurrent ischemic events, including stent thrombosis and restenosis.
• Antiplatelet drug resistance is increasingly recognized as a potential contributor to these adverse outcomes.

Purpose of the Study:

• To review the mechanisms of aspirin and clopidogrel resistance.
• To discuss the clinical significance and prognostic value of antiplatelet resistance after coronary interventions.
• To highlight the need for further research into laboratory detection and management of antiplatelet resistance.

Main Methods:

• Literature review of published data on antiplatelet resistance.
• Analysis of mechanisms including poor compliance, drug interactions, genetic polymorphism, and increased platelet turnover.
• Evaluation of clinical significance and prognostic implications of resistance.

Main Results:

• Resistance to aspirin and clopidogrel can manifest through various mechanisms.
• Antiplatelet resistance may be associated with stent thrombosis and other ischemic events post-intervention.
• Laboratory detection of resistance requires further validation for clinical utility.

Conclusions:

• Aspirin and clopidogrel resistance is a potential factor in recurrent ischemic events after coronary stenting.
• Understanding resistance mechanisms is crucial for optimizing antiplatelet strategies.
• Further research is needed to establish the clinical role of antiplatelet resistance testing.