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Clopidogrel response variability and its correlation with early recurrent cardiovascular events in chinese patients
Yamin Liu1, Naifeng Liu, Weilan Li
1Research Division of Pharmacology, China Pharmaceutical University, Nanjing, China.
Insights
Clopidogrel response varies significantly in Chinese patients after percutaneous coronary intervention. Non-responsiveness to clopidogrel increases the risk of early recurrent cardiovascular events.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- Clopidogrel response variability is well-documented in Caucasian populations.
- Limited data exists on clopidogrel's antiplatelet effects in Chinese patients undergoing PCI.
- This study addresses the gap in understanding clopidogrel efficacy in this demographic.
Purpose of the Study:
- To evaluate clopidogrel's antiplatelet effects in Chinese patients.
- To assess the correlation between clopidogrel responsiveness and early recurrent cardiovascular events.
Main Methods:
- 111 Chinese patients undergoing PCI were studied.
- Platelet aggregation and P-selectin expression were measured post-clopidogrel loading dose.
- Cardiovascular events were monitored for 3 months.
Main Results:
- Significant interindividual variability in clopidogrel response was observed.
- Non-responders showed significantly higher platelet aggregation rates.
- Non-responsiveness was linked to a higher incidence of early recurrent CV events (32.4% vs. 7.1% and 0%).
Conclusions:
- Clopidogrel's antiplatelet effectiveness exhibits wide interindividual variation in Chinese patients.
- Non-responsiveness to clopidogrel is a significant risk factor for early recurrent cardiovascular events.
Background/Aims:
Numerous studies conducted on Caucasian patients have reported that individual responsiveness to clopidogrel varies widely, whereas there are only a few published studies on the antiplatelet effect of clopidogrel therapy in Chinese patients undergoing percutaneous coronary intervention. The present study aimed to evaluate clopidogrel antiplatelet effects and their correlation with early recurrent cardiovascular (CV) events.
Methods:
Platelet aggregation (with 5 and 20 μmol/l ADP) and the expression of glycoprotein Ib and P-selectin were measured at baseline and 12 and 36 h after the clopidogrel loading dose in 111 consecutive patients. The primary outcome was a definite CV event.
Results:
There was marked interindividual variability in the drug response, as measured by platelet aggregation and P-selectin expression. The proportions of nonresponders at 12 and 36 h were 32 and 19%, respectively, with 5 μmol/l ADP, 38 and 28% with 20 μmol/l ADP, and 27 and 17% according to P-selectin expression. The maximal aggregation rates stimulated by 5 μmol/l ADP in nonresponders were significantly higher than those of the responders at 12 h (57.53 ± 14.24% vs. 33.91 ± 10.79%; p < 0.0001) and at 36 h (48.65 ± 15.46% vs. 30.31 ± 16.04%; p < 0.0001). During the 3-month follow-up period, 11 patients (32.4%) among the nonresponders, 2 patients (7.1%) among the low responders and none of the responders suffered a recurrent CV event (p < 0.0001).
Conclusions:
The antiplatelet effectiveness of clopidogrel has a wide interindividual variation, and nonresponsiveness to clopidogrel is associated with an increased risk of early recurrent CV events.
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