Nonresponsiveness to Clopidogrel and Subsequent Drug-Eluting Stent Thrombosis

A high rate of platelet aggregation after clopidogrel administration was associated with an increase in risk for DES thrombosis.

In a prospective study, investigators in Italy examined the effect of platelet reactivity on drug-eluting stent (DES) thrombosis in 804 consecutive patients who underwent DES implantation for any reason. Platelet reactivity was assessed with light transmission aggregometry in response to 10 µmol/L adenosine 5’-diphosphate 12 to 18 hours after a loading dose (600 mg) of clopidogrel (or 6 days later on a 75-mg maintenance dose of clopidogrel for patients who received a glycoprotein IIb/IIIa inhibitor). All patients received 325 mg of aspirin. Thirteen percent of patients (n=105) had platelet aggregation >70% (≥90th percentile of control patients’ reactivity) and were classified as clopidogrel nonresponders.

Nonresponders were older, more likel…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI