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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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Clopidogrel resistance is associated with long-term thrombotic events in patients implanted with drug-eluting stents

Lin Wang1, Xiaobei Wang, Fenghua Chen

  • 1Department of Laboratory Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Drugs in R&D
|December 22, 2010
PubMed

Insights

Clopidogrel resistance, common in patients with drug-eluting stents (DES), significantly increases the risk of thrombotic events like myocardial infarction and stent thrombosis. Diabetes, smoking, and high BMI are key risk factors for this resistance.

Area of Science:

  • Cardiology
  • Pharmacology
  • Interventional Cardiology

Background:

  • Limited prospective data exists on clopidogrel resistance and clinical outcomes in patients undergoing selective coronary drug-eluting stent (DES) implantation.
  • Understanding clopidogrel resistance is crucial for managing patients post-percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To investigate the association between clopidogrel resistance and long-term thrombotic events in patients with selective coronary DES implantation.
  • To identify factors contributing to clopidogrel resistance in this patient cohort.

Main Methods:

  • 154 patients undergoing selective PCI with DES were enrolled.
  • Platelet aggregation was measured using light transmittance aggregometry (LTA) pre- and post-clopidogrel administration.
  • Clopidogrel resistance was defined as ≤10% absolute difference in LTA.
  • Patients were followed for 1 year for major adverse cardiovascular events and stent thrombosis.

Main Results:

  • The incidence of clopidogrel resistance was 20.28%.
  • Diabetes mellitus, smoking, and higher body mass index (BMI) were associated with clopidogrel resistance.
  • Clopidogrel-resistant patients had significantly higher rates of composite endpoints (21.88% vs. 4.92%) and stent thrombosis (12.5% vs. 1.64%) compared to responders.

Conclusions:

  • Diabetes, smoking, and high BMI are significant risk factors for clopidogrel resistance.
  • Clopidogrel resistance is a strong predictor of increased long-term thrombotic events, including stent thrombosis, in patients with DES.
Abstract

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