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Published on: March 15, 2022

Low responsiveness to clopidogrel increases risk among CKD patients undergoing coronary intervention

Patrik Htun1, Suzanne Fateh-Moghadam, Christian Bischofs

  • 1Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Universitätsklinikum der Eberhard-Karls-Universität Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, Germany.

Journal of the American Society of Nephrology : JASN
|January 29, 2011
PubMed

Insights

Patients with chronic kidney disease (CKD) show reduced responsiveness to clopidogrel, increasing their risk for major cardiovascular events after percutaneous coronary intervention (PCI). Low clopidogrel response is a significant predictor of poorer outcomes in CKD patients undergoing PCI.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Patients with chronic kidney disease (CKD) face elevated risks for major adverse events following percutaneous coronary intervention (PCI) compared to those with normal renal function.
  • Understanding antiplatelet drug response in CKD patients is crucial for optimizing post-PCI outcomes.

Purpose of the Study:

  • To assess clopidogrel responsiveness in patients diagnosed with stage 3 to 5 CKD.
  • To investigate the impact of antiplatelet drug response on outcomes after PCI in this patient cohort.

Main Methods:

  • Retrospective analysis of 1567 patients with symptomatic coronary artery disease undergoing PCI.
  • Assessment of clopidogrel responsiveness via ADP-induced platelet aggregation after a 600-mg loading dose and 100 mg aspirin.
  • Multivariate survival analysis of 1335 patients to identify predictors of the primary endpoint (myocardial infarction, ischemic stroke, death within 1 year).

Main Results:

  • Stage 3 to 5 CKD was identified as an independent predictor of adverse post-PCI outcomes.
  • Low response to clopidogrel was also found to be an independent predictor of the primary endpoint.
  • These factors were associated with increased risk for myocardial infarction, ischemic stroke, and death within one year post-PCI.

Conclusions:

  • Reduced responsiveness to clopidogrel may represent an additional risk factor contributing to poorer outcomes in CKD patients undergoing PCI.
  • Optimizing antiplatelet therapy and considering renal function are vital for improving post-PCI prognosis in patients with CKD.

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