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Clopidogrel resistance--the cardiologist's perspective
Paul Fefer1, Hanoch Hod, Shlomi Matetzky
1Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel Aviv University, Israel. paul.fefer@sheba.health.gov.il
Insights
Clopidogrel resistance contributes to cardiovascular events in patients with acute coronary syndromes despite treatment. This review clarifies current knowledge on clopidogrel resistance and its impact.
Area of Science:
- Cardiology
- Pharmacology
- Thrombosis
Background:
- Platelet activation and aggregation are key in acute coronary syndromes (ACS) pathogenesis.
- Clopidogrel reduces atherothrombotic events post-percutaneous coronary intervention (PCI) and in ACS.
- A significant number of patients experience recurrent cardiovascular events despite clopidogrel therapy.
Purpose of the Study:
- To review and clarify current understanding of clopidogrel resistance.
- To explore the link between clopidogrel resistance and treatment failure in ACS patients.
Main Methods:
- Literature review of studies on clopidogrel resistance.
- Analysis of factors contributing to antiplatelet treatment failure.
Main Results:
- Evidence suggests clopidogrel resistance is a factor in treatment failure.
- Understanding resistance mechanisms is crucial for optimizing therapy.
Conclusions:
- Clopidogrel resistance is a significant clinical issue in acute coronary syndromes.
- Further research is needed to address and overcome clopidogrel resistance for improved patient outcomes.
Abstract:
Platelet activation and aggregation play a major role in the pathogenesis of acute coronary syndromes. While clopidogrel has convincingly been shown to reduce atherothrombotic events in patients with acute coronary syndromes, and following percutaneous coronary interventions (PCI), a significant portion of patients continue to suffer cardiovascular events. A growing body of literature suggests that at least part of this treatment failure can be attributed to resistance to anti-thrombotic treatment in these patients. The purpose of this review is to clarify the current knowledge regarding clopidogrel resistance.
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