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Updated: May 11, 2026
09:25
Methods to Evaluate Cytotoxicity and Immunosuppression of Combustible Tobacco Product Preparations
Published on: January 10, 2015
Thienopyridine efficacy and cigarette smoking status.
Kevin P Bliden1, Brian A Baker, Thomas D Nolin
1Sinai Center for Thrombosis Research, Baltimore, MD 21215, USA.
American Heart Journal
|April 30, 2013
Summary
Smokers show greater cardiovascular event reduction with clopidogrel than nonsmokers. This "smoker's paradox" suggests smoking influences clopidogrel
Area of Science:
- Cardiology
- Pharmacology
Background:
- Dual antiplatelet therapy (aspirin and P2Y12 blockers) is standard for high-risk cardiovascular disease.
- Cigarette smoking is a major cardiovascular risk factor.
- A
- smoker's paradox
- suggests clopidogrel is less effective in nonsmokers.
Purpose of the Study:
- To critically evaluate the interaction between smoking status and thienopyridine (clopidogrel) efficacy.
- To review pharmacodynamic and clinical outcome data regarding this interaction.
Main Methods:
- Review of large-scale clinical trials and "real-world" data.
- Analysis of pharmacodynamic studies in healthy volunteers, acute coronary syndrome, and percutaneous coronary intervention patients.
Main Results:
- Multiple studies indicate a reduced CV-event reduction in clopidogrel-treated nonsmokers compared to smokers.
- Pharmacodynamic data show smoking influences clopidogrel responsiveness.
- Evidence suggests a reduced antiplatelet effect of clopidogrel in nonsmokers.
Conclusions:
- A significant body of evidence supports a reduced clopidogrel antiplatelet effect in nonsmokers versus smokers.
- The clinical relevance of this interaction requires further prospective investigation.
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