Aspirin-Resistant Patients May Not Respond to Clopidrogel

Dual drug-resistant patients at risk for thrombotic complications after angioplasty

FRIDAY, Dec. 30 (HealthDay News) -- Aspirin-resistant patients undergoing percutaneous coronary intervention (PCI) often have a decreased response to clopidrogel as well, according to a study in the January issue of the Journal of the American College of Cardiology. This distinctive group of dual drug-resistant patients may be at higher risk for thrombotic complications after PCI.

Eli I. Lev, M.D., of Baylor College of Medicine in Houston, Texas, and colleagues studied 150 angioplasty patients who received aspirin for one week or more but not clopidrogel. Blood was drawn at baseline and 20 to 24 hours after a 300-mg clopidrogel dose. All patients received bivalirudin during angioplasty.

The researchers report that 19 patients (12.7%) were aspirin-resistant, and 36 (24%) were clopidrogel-resistant. Nine of the aspirin-resistant patients were also clopidrogel-resistant (47.4%). The aspirin-resistant patients were more apt to be women and have diabetes than the aspirin-sensitive patients, the investigators found.

"Aspirin-resistant patients as a group have reduced response to clopidrogel," the authors write. "Furthermore, we have identified a unique group of dual drug-resistant patients who may be at increased risk for thrombotic complications after PCI."

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