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Published on: March 15, 2022

Dual antiplatelet drug resistance is a risk factor for cardiovascular events after percutaneous coronary intervention

Boris T Ivandic1, Mareike Sausemuth, Hesham Ibrahim

  • 1Department of Medicine III, University of Heidelberg, Germany. boris.ivandic@med.uni-heidelberg.de

Clinical Chemistry
|April 11, 2009
PubMed

Insights

Dual nonresponsiveness to antiplatelet drugs like clopidogrel and aspirin significantly increases cardiovascular risk after percutaneous coronary intervention. Patients identified as dual nonresponders require intensified treatment and closer monitoring.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Nonresponsiveness to clopidogrel and acetylsalicylic acid (ASA) is common in platelet aggregometry studies.
  • The clinical and prognostic significance of this dual nonresponsiveness remains unclear.

Purpose of the Study:

  • To investigate the clinical significance of dual nonresponsiveness to clopidogrel and ASA after percutaneous coronary intervention (PCI).
  • To identify the prevalence and prognostic implications of dual nonresponsiveness in patients undergoing PCI.

Main Methods:

  • Impedance aggregometry was used to assess platelet inhibition in 182 patients post-PCI and clopidogrel loading.
  • Pharmacodynamic and pharmacokinetic resistance were distinguished through in vitro testing.
  • A composite endpoint of major adverse cardiovascular events was evaluated.

Main Results:

  • 10.4% of patients were dual nonresponders to clopidogrel and ASA.
  • Dual nonresponders experienced significantly higher rates of the primary endpoint (31.6%) compared to responders (12.3%).
  • Dual nonresponsiveness was identified as an independent risk factor for adverse cardiovascular events.

Conclusions:

  • Dual nonresponders exhibit a high cardiovascular risk following PCI.
  • Intensified antiplatelet therapy and enhanced follow-up are recommended for dual nonresponders.
Abstract

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