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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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The influence of clopidogrel on ischemia diagnosed by myocardial perfusion stress testing

Ion S Jovin1,2, Keita A Ebisu3, Adriana D Oprea4

  • 1Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA. isjovin@yahoo.com.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|September 5, 2015
PubMed

Insights

Clopidogrel does not appear to affect the diagnosis of myocardial ischemia during stress tests. This study found no evidence that clopidogrel use decreases the likelihood of detecting ischemia on myocardial perfusion scans.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Pharmacology

Background:

  • Clopidogrel, a platelet adenosine receptor antagonist, may affect coronary vascular tone.
  • This potential effect could interfere with myocardial perfusion imaging.
  • The study aimed to determine if clopidogrel use impacts ischemia diagnosis in myocardial perfusion testing.

Purpose of the Study:

  • To investigate the impact of clopidogrel on the diagnosis of myocardial ischemia.
  • To assess whether clopidogrel use influences the detection of reversible perfusion defects in myocardial perfusion imaging.

Main Methods:

  • Analysis of 6349 myocardial perfusion stress tests.
  • Propensity analysis comparing patients on clopidogrel versus those not.
  • Evaluation of reversible perfusion defects using single-photon emission computed tomography (SPECT) scans.

Main Results:

  • The unadjusted odds ratio for reversible perfusion defects in clopidogrel users was 2.75 (P < .01).
  • After propensity adjustment, the odds ratio was 1.06 for adenosine stress tests (P = .73) and 1.60 for exercise stress tests (P = .14).
  • No statistically significant association was found between clopidogrel use and the presence of reversible perfusion defects after adjustment.

Conclusions:

  • Clopidogrel use did not decrease the likelihood of ischemia detection.
  • No evidence suggests clopidogrel hampers the diagnosis of ischemia in myocardial perfusion scans.
  • The findings support the continued use of myocardial perfusion imaging in patients taking clopidogrel.
Abstract

Keywords:
Myocardial perfusionclopidogrelcoronary vascular toneimaging

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