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Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu01:29

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Clopidogrel resistance: the way forward.

Shuvanan Ray1

  • 1Chief of Interventional Cardiology, Fortis Hospitals Limited, 730 Anandapur, Beside Calcutta International School, EM Bypass, Kasba, East Kolkata Township, Kolkata 700107, India.

Indian Heart Journal
|December 3, 2014
PubMed
Summary
This summary is machine-generated.

Clopidogrel resistance in Acute Coronary Syndrome (ACS) patients increases mortality and stent thrombosis. This review explores resistance causes, evaluation, global incidence, clinical impact, and solutions, including newer antiplatelets.

Keywords:
Clopidogrel resistancePlatelet reactivityPrasugrelStent thrombosisTicagrelor

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Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Clopidogrel, a thienopyridine, is a primary treatment for Acute Coronary Syndrome (ACS).
  • Clopidogrel resistance is linked to higher mortality and stent thrombosis in ACS patients.
  • Understanding resistance mechanisms is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To investigate the causes and contributing factors of clopidogrel resistance.
  • To review laboratory methods for evaluating clopidogrel resistance.
  • To assess the global and Indian incidence, clinical significance, and management strategies for clopidogrel resistance.

Main Methods:

  • Literature review of studies on clopidogrel resistance in ACS.
  • Analysis of factors influencing clopidogrel efficacy.
  • Examination of diagnostic and therapeutic approaches.

Main Results:

  • Clopidogrel resistance is multifactorial, influenced by genetic, clinical, and drug-related factors.
  • Laboratory evaluations can identify patients with resistance.
  • Global and Indian incidence data highlight the widespread nature of this issue.

Conclusions:

  • Clopidogrel resistance significantly impacts cardiovascular event rates in ACS patients.
  • Identifying and managing resistance is essential for improving patient prognosis.
  • Exploring alternative antiplatelet agents is a key strategy for overcoming resistance.