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Prevalence of older in-patients at risk of clopidogrel resistance according to the STIB score. Results from REPOSI registry

Published:April 11, 2017DOI:https://doi.org/10.1016/j.ejim.2017.03.024
      Clopidogrel and acetylsalicylic acid are cornerstones of treatment of the acute coronary syndromes (ACS) and percutaneous coronary interventions (PCI) [
      • Legrand D.
      • Barbato E.
      • Chenu P.
      • Magne J.
      • Vrolix M.
      • Wijns W.
      • et al.
      The STIB score: a simple clinical test to predict clopidogrel resistance.
      ]. The problem of clopidogrel resistance was the object of numerous studies which showed that high platelet reactivity (HPR) in patients treated with this drug is a strong predictor of the risk of ischemic events in patients undergoing PCI [
      • Valenti R.
      • Marcucci R.
      • Comito V.
      • Marrani M.
      • Cantini G.
      • Migliorini A.
      • et al.
      Prasugrel in clopidogrel nonresponders undergoing percutaneous coronary intervention: the RECLOSE-3 study (REsponsiveness to CLOpidogrel and StEnt thrombosis).
      ]; [
      • Cuisset T.
      • Frere C.
      • Quilici J.
      • Gaborit B.
      • Castelli C.
      • Poyet R.
      • et al.
      Predictive values of post-treatment adenosine diphosphate-induced aggregation and vasodilator-stimulated phosphoprotein index for stent thrombosis after acute coronary syndrome in clopidogrel-treated patients.
      ]; [
      • Buonamici P.
      • Marcucci R.
      • Migliorini A.
      • Gensini G.F.
      • Santini A.
      • Paniccia R.
      • et al.
      Impact of platelet reactivity after clopidogrel administration on drug-eluting stent thrombosis.
      ]; [
      • Bonello L.
      • Paganelli F.
      • Arpin-Bornet M.
      • Auquier P.
      • Sampol J.
      • Dignat-George F.
      • et al.
      Vasodilator-stimulated phosphoprotein phosphorylation analysis prior to percutaneous coronary intervention for exclusion of postprocedural major adverse cardiovascular events.
      ]; [
      • Gurbel P.A.
      • Tantry U.S.
      An initial experiment with personalized antiplatelet therapy: the GRAVITAS trial.
      ]. Matetzky and colleagues showed that 25% of patients undergoing PCI after a previous STEMI were resistant to clopidogrel and therefore at an increased risk of adverse cardiovascular events [
      • Matetzky S.
      • Shenkman B.
      • Guetta V.
      • Shechter M.
      • Beinart R.
      • Goldenberg I.
      • et al.
      Clopidogrel resistance is associated with increased risk of recurrent atherothrombotic events in patients with acute myocardial infarction.
      ]. In another study, Price and colleagues measured HPR in patients treated with clopidogrel with a point-of-care test, showing that HPR was associated with cardiovascular adverse events that occurred after patient discharge from hospital [
      • Price M.J.
      • Endemann S.
      • Gollapudi R.R.
      • Valencia R.
      • Stinis C.T.
      • Levisay J.P.
      • et al.
      Prognostic significance of post-clopidogrel platelet reactivity assessed by a point-of-care assay on thrombotic events after drug-eluting stent implantation.
      ].

      Keywords

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