Smoking Enhances Platelet Inhibition by Clopidogrel

Results of an observational study substantiate a possible contributor to the variation in patient response to clopidogrel.

High residual platelet activity has been associated with adverse ischemic events after percutaneous coronary intervention, and variability in platelet inhibition by clopidogrel may contribute to such events. Noting that cigarette smoking can induce a hepatic enzyme that converts clopidogrel to its active metabolite, investigators examined the effect of smoking on platelet response to clopidogrel after elective coronary stenting in 104 current smokers and 155 nonsmokers. Platelet aggregation was assessed by conventional light-transmission aggregometry 18 to 24 hours after PCI in patients who did not receive a glycoprotein (GP) IIb/IIIa inhibitor and ≥5 days after PCI in those who did.

Aggregation induced by adenosine diphosphate (ADP; 20 μmol…

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

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)