Key result
Clopidogrel resistance linked to ~18-fold higher recurrent cardiovascular events at 6 months after primary PCI.
Why the study?
Although clopidogrel reduces cardiovascular risk after coronary events and stenting, a substantial number of incidents continue to occur, and the impact of clopidogrel resistance on outcomes is unclear.
Does clopidogrel resistance increase the risk of recurrent cardiovascular events in STEMI patients undergoing primary PCI with stenting?
Population
60 consecutive STEMI patients undergoing primary PCI with stenting
Comparison
Clopidogrel resistant patients (lowest quartile of ADP-induced platelet aggregation reduction) vs clopidogrel responders (higher quartiles)
Design
Prospective cohort study
Follow-up
6 months
Authors
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Clopidogrel resistance may identify higher-risk STEMI patients after PCI; leaves open whether resistance-guided therapy improves outcomes.
Cohort (n=60)
Does clopidogrel resistance increase the risk of recurrent cardiovascular events in STEMI patients undergoing primary PCI with stenting?
Absolute Event Rate: 40% vs 2.2%
p-value: p=0.007
Clopidogrel resistance, present in up to 25% of STEMI patients undergoing primary PCI, is significantly associated with an increased risk of recurrent cardiovascular events at 6 months.
Matetzky et al. (2004) conducted a cohort in Acute ST-segment-elevation myocardial infarction (STEMI) (n=60). Clopidogrel resistance vs. Clopidogrel responsiveness was evaluated on Recurrent cardiovascular event (p=0.007). Clopidogrel resistance in STEMI patients undergoing primary PCI was associated with a higher rate of recurrent cardiovascular events at 6 months (40% vs 2.2% in responsive patients, P=0.007).
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