How Should Clopidogrel Nonresponders Be Treated?

Two different approaches show promise in small randomized trials.

The evidence is clear that individual response to clopidogrel varies widely and that poorly responsive patients are at increased risk for cardiovascular events. In two new studies from France, investigators assessed potential treatment options for such patients.

In the Vasodilator-Stimulated Phosphoprotein (VASP)-02 study, investigators used VASP phosphorylation to measure clopidogrel responsiveness in 153 patients before and after clopidogrel loading prior to elective percutaneous coronary intervention. Participants were then randomly assigned to receive clopidogrel 75 mg/day or 150 mg/day for 2 weeks, followed by repeat VASP analysis. Patients who had a platelet reactivity index (PRI) of >69% were deemed low responders to clopidogrel, and …

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