The clopidogrel resistance can be attenuated with triple antiplatelet therapy in patients undergoing drug-eluting stents implantation

Chi Young Shim, Se Jung Yoon, Sungha Park, Jung Sun Kim, Jong Rak Choi, Young Guk Ko, Donghoon Choi, Jong Won Ha, Yangsoo Jang, Namsik Chung, Won Heum Shim, Seung Yun Cho

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Abstract

Background: Triple antiplatelet therapy may have a beneficial effect on prevention of thrombotic complication in patients undergoing coronary stenting. We investigated the prevalence of aspirin and clopidogrel resistance in patients treated with dual and triple antiplatelet regimen after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 400 consecutive patients underwent successful PCI with DES were randomly assigned to therapy with dual antiplatelet regimens (aspirin plus clopidogrel, Group I, n = 200) and triple antiplatelet regimens (aspirin plus clopidogrel plus cilostazol, Group II, n = 200) At two weeks after PCI, aspirin and clopidogrel resistance were assayed in 379 patients (Group I, n = 186; Group II, n = 193) by using the VerifyNow System. Results: In Group I, 21 (11.3%) patients had aspirin resistance and 74 (40.0%) had clopidogrel resistance. In Group II, 19 (9.8%) were resistant to aspirin and 38 (19.7%) to clopidogrel. The aspirin reaction unit (ARU) was not significantly different between groups (448 ± 67 vs. 439 ± 64, P = 0.200), but the percent inhibition of clopidogrel was higher in Group II (41.4 ± 24.3%,) comparing with that of Group I (26.5 ± 18.7%, P < 0.001). Conclusion: With triple antiplatelet therapy, the prevalence of clopidogrel resistance can be attenuated in patients undergoing PCI with DES.

Original languageEnglish
Pages (from-to)351-355
Number of pages5
JournalInternational Journal of Cardiology
Volume134
Issue number3
DOIs
Publication statusPublished - 2009 May 29

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clopidogrel
Drug-Eluting Stents
Aspirin
Percutaneous Coronary Intervention
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Shim, Chi Young ; Yoon, Se Jung ; Park, Sungha ; Kim, Jung Sun ; Choi, Jong Rak ; Ko, Young Guk ; Choi, Donghoon ; Ha, Jong Won ; Jang, Yangsoo ; Chung, Namsik ; Shim, Won Heum ; Cho, Seung Yun. / The clopidogrel resistance can be attenuated with triple antiplatelet therapy in patients undergoing drug-eluting stents implantation. In: International Journal of Cardiology. 2009 ; Vol. 134, No. 3. pp. 351-355.
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title = "The clopidogrel resistance can be attenuated with triple antiplatelet therapy in patients undergoing drug-eluting stents implantation",
abstract = "Background: Triple antiplatelet therapy may have a beneficial effect on prevention of thrombotic complication in patients undergoing coronary stenting. We investigated the prevalence of aspirin and clopidogrel resistance in patients treated with dual and triple antiplatelet regimen after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 400 consecutive patients underwent successful PCI with DES were randomly assigned to therapy with dual antiplatelet regimens (aspirin plus clopidogrel, Group I, n = 200) and triple antiplatelet regimens (aspirin plus clopidogrel plus cilostazol, Group II, n = 200) At two weeks after PCI, aspirin and clopidogrel resistance were assayed in 379 patients (Group I, n = 186; Group II, n = 193) by using the VerifyNow System. Results: In Group I, 21 (11.3{\%}) patients had aspirin resistance and 74 (40.0{\%}) had clopidogrel resistance. In Group II, 19 (9.8{\%}) were resistant to aspirin and 38 (19.7{\%}) to clopidogrel. The aspirin reaction unit (ARU) was not significantly different between groups (448 ± 67 vs. 439 ± 64, P = 0.200), but the percent inhibition of clopidogrel was higher in Group II (41.4 ± 24.3{\%},) comparing with that of Group I (26.5 ± 18.7{\%}, P < 0.001). Conclusion: With triple antiplatelet therapy, the prevalence of clopidogrel resistance can be attenuated in patients undergoing PCI with DES.",
author = "Shim, {Chi Young} and Yoon, {Se Jung} and Sungha Park and Kim, {Jung Sun} and Choi, {Jong Rak} and Ko, {Young Guk} and Donghoon Choi and Ha, {Jong Won} and Yangsoo Jang and Namsik Chung and Shim, {Won Heum} and Cho, {Seung Yun}",
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The clopidogrel resistance can be attenuated with triple antiplatelet therapy in patients undergoing drug-eluting stents implantation. / Shim, Chi Young; Yoon, Se Jung; Park, Sungha; Kim, Jung Sun; Choi, Jong Rak; Ko, Young Guk; Choi, Donghoon; Ha, Jong Won; Jang, Yangsoo; Chung, Namsik; Shim, Won Heum; Cho, Seung Yun.

In: International Journal of Cardiology, Vol. 134, No. 3, 29.05.2009, p. 351-355.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The clopidogrel resistance can be attenuated with triple antiplatelet therapy in patients undergoing drug-eluting stents implantation

AU - Shim, Chi Young

AU - Yoon, Se Jung

AU - Park, Sungha

AU - Kim, Jung Sun

AU - Choi, Jong Rak

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Ha, Jong Won

AU - Jang, Yangsoo

AU - Chung, Namsik

AU - Shim, Won Heum

AU - Cho, Seung Yun

PY - 2009/5/29

Y1 - 2009/5/29

N2 - Background: Triple antiplatelet therapy may have a beneficial effect on prevention of thrombotic complication in patients undergoing coronary stenting. We investigated the prevalence of aspirin and clopidogrel resistance in patients treated with dual and triple antiplatelet regimen after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 400 consecutive patients underwent successful PCI with DES were randomly assigned to therapy with dual antiplatelet regimens (aspirin plus clopidogrel, Group I, n = 200) and triple antiplatelet regimens (aspirin plus clopidogrel plus cilostazol, Group II, n = 200) At two weeks after PCI, aspirin and clopidogrel resistance were assayed in 379 patients (Group I, n = 186; Group II, n = 193) by using the VerifyNow System. Results: In Group I, 21 (11.3%) patients had aspirin resistance and 74 (40.0%) had clopidogrel resistance. In Group II, 19 (9.8%) were resistant to aspirin and 38 (19.7%) to clopidogrel. The aspirin reaction unit (ARU) was not significantly different between groups (448 ± 67 vs. 439 ± 64, P = 0.200), but the percent inhibition of clopidogrel was higher in Group II (41.4 ± 24.3%,) comparing with that of Group I (26.5 ± 18.7%, P < 0.001). Conclusion: With triple antiplatelet therapy, the prevalence of clopidogrel resistance can be attenuated in patients undergoing PCI with DES.

AB - Background: Triple antiplatelet therapy may have a beneficial effect on prevention of thrombotic complication in patients undergoing coronary stenting. We investigated the prevalence of aspirin and clopidogrel resistance in patients treated with dual and triple antiplatelet regimen after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 400 consecutive patients underwent successful PCI with DES were randomly assigned to therapy with dual antiplatelet regimens (aspirin plus clopidogrel, Group I, n = 200) and triple antiplatelet regimens (aspirin plus clopidogrel plus cilostazol, Group II, n = 200) At two weeks after PCI, aspirin and clopidogrel resistance were assayed in 379 patients (Group I, n = 186; Group II, n = 193) by using the VerifyNow System. Results: In Group I, 21 (11.3%) patients had aspirin resistance and 74 (40.0%) had clopidogrel resistance. In Group II, 19 (9.8%) were resistant to aspirin and 38 (19.7%) to clopidogrel. The aspirin reaction unit (ARU) was not significantly different between groups (448 ± 67 vs. 439 ± 64, P = 0.200), but the percent inhibition of clopidogrel was higher in Group II (41.4 ± 24.3%,) comparing with that of Group I (26.5 ± 18.7%, P < 0.001). Conclusion: With triple antiplatelet therapy, the prevalence of clopidogrel resistance can be attenuated in patients undergoing PCI with DES.

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