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Related Experiment Video

Updated: May 15, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Clopidogrel hyper-response and bleeding risk in neurointerventional procedures.

C Goh1, L Churilov, P Mitchell

  • 1Department of Radiology, Neurointervention Service, Comprehensive Stroke Centre, Royal Melbourne Hospital, and Department of Mathematics and Statistics, University of Melbourne, Melbourne, Australia.

AJNR. American Journal of Neuroradiology
|January 1, 2013
PubMed
Summary

High platelet inhibition from clopidogrel, known as hyper-response, increases the risk of bleeding complications after neurointerventional procedures. Further research is needed to define hyper-response thresholds.

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Last Updated: May 15, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Area of Science:

  • Neuroscience
  • Pharmacology
  • Cardiology

Background:

  • Antiplatelet therapy is crucial for preventing ischemic events post-neurointervention.
  • Antiplatelet resistance can lead to treatment failure.
  • The link between antiplatelet hyper-response and bleeding risk is not well-understood.

Purpose of the Study:

  • To investigate the association between antiplatelet hyper-response and hemorrhagic complications.
  • To determine if excessive platelet inhibition correlates with bleeding risk.

Main Methods:

  • Prospective recruitment of patients undergoing neurointerventional procedures on antiplatelet medication.
  • Assessment of P2Y12 receptor-mediated platelet inhibition using the VerifyNow assay.
  • Collection of data on demographics, risk factors, treatments, and hemorrhagic complications.
  • Logistic regression and ROC analysis to evaluate platelet inhibition as a predictor of bleeding.

Main Results:

  • Ten out of 47 patients (21.3%) experienced hemorrhagic complications.
  • Patients with major bleeding showed significantly higher clopidogrel response (94% inhibition) compared to those without (24% inhibition).
  • Hyper-responders (≥72% inhibition) had a 42.8% rate of major bleeding complications.

Conclusions:

  • Hyper-response to clopidogrel is linked to an elevated risk of hemorrhagic complications.
  • Larger studies are required to establish definitive thresholds for clopidogrel hyper-response.
  • Further research should explore the impact of adjusting antiplatelet dosages in hyper-responders.