Incidence and Clinical Impact of Dual Nonresponsiveness to Aspirin and Clopidogrel in Patients With Drug-Eluting Stents

• Published in: Journal of the American College of Cardiology Vol. 52; no. 9; pp. 734 - 739
• Main Authors: Gori, Anna Maria, MD, Marcucci, Rossella, MD, Migliorini, Angela, MD, Valenti, Renato, MD, Moschi, Guia, MD, Paniccia, Rita, MD, Buonamici, Piergiovanni, MD, Gensini, Gian Franco, MD, Vergara, Ruben, MD, Abbate, Rosanna, MD, Antoniucci, David, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 26.08.2008; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Aspirin - pharmacology; Cardiology; Cardiovascular; clopidogrel; Cohort Studies; Coronary Artery Disease - blood; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - therapy; Coronary vessels; Drug Resistance, Multiple; Drug therapy; drug-eluting stent; Drug-Eluting Stents; Female; Graft Occlusion, Vascular - diagnosis; Graft Occlusion, Vascular - epidemiology; Graft Occlusion, Vascular - prevention & control; Heart attacks; Humans; Incidence; Internal Medicine; Male; Middle Aged; nonresponsiveness; Platelet Activation - drug effects; Platelet Aggregation Inhibitors - pharmacology; Radiography; Risk Factors; stent thrombosis; Stents; Ticlopidine - analogs & derivatives; Ticlopidine - pharmacology; clopidogrel; drug-eluting stent; CI; GP; HR; ADP; drug-eluting stent(s); nonresponsiveness; DES; stent thrombosis; adenosine 5′-diphosphate; hazard ratio; confidence interval; glycoprotein
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2008.05.032

Incidence and Clinical Impact of Dual Nonresponsiveness to Aspirin and Clopidogrel in Patients With Drug-Eluting Stents Anna Maria Gori, Rossella Marcucci, Angela Migliorini, Renato Valenti, Guia Moschi, Rita Paniccia, Piergiovanni Buonamici, Gian Franco Gensini, Ruben Vergara, Rosanna Abbate, David Antoniucci This study sought to determine the incidence of aspirin nonresponsiveness in addition to clopidogrel nonresponsiveness and whether this association identifies patients at an increased risk of drug-eluting stent (DES) thrombosis in 746 patients. The incidence of dual nonresponsiveness to aspirin and clopidogrel was 6%. Dual clopidogrel and aspirin nonresponsiveness was an independent predictor of DES thrombosis (hazard ratio [HR]: 3.18, 95% confidence interval [CI]: 1.14 to 8.83, p = 0.027) and the composite of cardiac mortality and DES thrombosis (HR: 2.94, 95% CI: 1.16 to 7.41, p = 0.022).