Prevalence of Aspirin and Clopidogrel Resistance Among Patients With and Without Drug-Eluting Stent Thrombosis
Drug-eluting stent (DES) thrombosis has a multifactorial etiology. Variable responsiveness to antiplatelet therapy likely contributes to its pathogenesis. We aimed to determine whether patients who had experienced DES thrombosis compared with a cohort of patients who had not would exhibit greater pl...
Gespeichert in:
| Veröffentlicht in: | The American journal of cardiology 2009-08, Vol.104 (4), p.525-530 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 530 |
|---|---|
| container_issue | 4 |
| container_start_page | 525 |
| container_title | The American journal of cardiology |
| container_volume | 104 |
| creator | Pinto Slottow, Tina L., MD Bonello, Laurent, MD Gavini, Rekha, BS Beauzile, Patricia, BS Sushinsky, Steven J., BS Scheinowitz, Mickey, PhD Kaneshige, Kimberly, BS Xue, Zhenyi, MS Torguson, Rebecca, MPH Tantry, Udaya, PhD Pichard, Augusto D., MD Satler, Lowell F., MD Suddath, William O., MD Kent, Kenneth, MD, PhD Gurbel, Paul, MD Waksman, Ron, MD |
| description | Drug-eluting stent (DES) thrombosis has a multifactorial etiology. Variable responsiveness to antiplatelet therapy likely contributes to its pathogenesis. We aimed to determine whether patients who had experienced DES thrombosis compared with a cohort of patients who had not would exhibit greater platelet reactivity and a greater prevalence of aspirin and clopidogrel resistance. The effect of aspirin and clopidogrel on platelet reactivity was determined after angiographically proven DES thrombosis in 26 patients and in 21 patients who had not experienced stent thrombosis (ST) ≥18 months after DES implantation. Aspirin effect was assessed using the VerifyNow Aspirin Assay, and the effect of clopidogrel was assessed using the VerifyNow P2Y12 Assay and vasodilator-stimulated phosphoprotein phosphorylation (VASP-P). Aspirin resistance was present in 23% of patients with ST and 5% of controls (p = NS). Clopidogrel resistance was present in 40% of patients with ST and 14% of controls using the P2Y12 assay (p = 0.02) and 90% of patients with ST and 67% of controls using the VASP-P assay (p = NS). Mean aspirin reaction units were significantly greater among all patients with ST and those with early ST compared with controls (477 ± 89 vs 429 ± 58, p = 0.04; and 485 ± 84 vs 429 ± 58, p = 0.02, respectively). Mean P2Y12 reaction units were significantly greater among patients with early ST compared with controls (265 ± 102 vs 184 ± 76, p = 0.01). The results of the VASP-P assay did not correlate with the presence of ST. In conclusion, patients who experienced DES thrombosis demonstrated significantly greater rates of clopidogrel resistance as determined by P2Y12 reaction units, but not VASP-P, compared with patients without DES thrombosis. Aspirin reaction units were significantly greater in the DES thrombosis population. Point-of-care testing with the VerifyNow Aspirin and P2Y12 Assays has the potential to identify patients at increased risk of ST, particularly early ST, after DES deployment. |
| doi_str_mv | 10.1016/j.amjcard.2009.04.015 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67557024</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0002914909009187</els_id><sourcerecordid>1825957621</sourcerecordid><originalsourceid>FETCH-LOGICAL-c475t-77b25e1959db248c863d16ba26907b6acf7b4d961f716c6397c987ed0692667a3</originalsourceid><addsrcrecordid>eNqFktFr1TAUxoMo7jr9E5Qi6FvrSdomzYtyuW4qDBxu4mNIk_QutW2uSTrYf7_UWybsRfKQBH7ny8n3HYReYygwYPqhL-TYK-l1QQB4AVUBuH6CNrhhPMccl0_RBgBIznHFT9CLEPp0xbimz9EJ5pRCWhs0XXpzKwczKZO5LtuGg_V2yuSks93gDla7vTdD9sMEG6JcqO3opn12KaM1UwzZLxtv_uLLwc0x--znfX42zNEm7ComKLu-8W5sXZJ4iZ51cgjm1bqfop_nZ9e7r_nF9y_fdtuLXFWsjjljLakN5jXXLaka1dBSY9pKQjmwlkrVsbbSnOKOYapoyZniDTMaKCeUMlmeovdH3YN3f2YTohhtUGYY5GTcHARldc2AVAl8-wjs3eyn1JsgJZSsIVAmqD5CyrsQvOnEwdtR-juBQSxpiF6saYglDQGVSGmkujer-NyORv-rWu1PwLsVkEHJofPJYRseOIIbwoGTxH06ciZ5dmuNF0HZJTNtvVFRaGf_28rHRwpqsJNNj_42dyY8fBqLQASIq2V0lskBnkTSTJX3wIm_Aw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>230378203</pqid></control><display><type>article</type><title>Prevalence of Aspirin and Clopidogrel Resistance Among Patients With and Without Drug-Eluting Stent Thrombosis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Pinto Slottow, Tina L., MD ; Bonello, Laurent, MD ; Gavini, Rekha, BS ; Beauzile, Patricia, BS ; Sushinsky, Steven J., BS ; Scheinowitz, Mickey, PhD ; Kaneshige, Kimberly, BS ; Xue, Zhenyi, MS ; Torguson, Rebecca, MPH ; Tantry, Udaya, PhD ; Pichard, Augusto D., MD ; Satler, Lowell F., MD ; Suddath, William O., MD ; Kent, Kenneth, MD, PhD ; Gurbel, Paul, MD ; Waksman, Ron, MD</creator><creatorcontrib>Pinto Slottow, Tina L., MD ; Bonello, Laurent, MD ; Gavini, Rekha, BS ; Beauzile, Patricia, BS ; Sushinsky, Steven J., BS ; Scheinowitz, Mickey, PhD ; Kaneshige, Kimberly, BS ; Xue, Zhenyi, MS ; Torguson, Rebecca, MPH ; Tantry, Udaya, PhD ; Pichard, Augusto D., MD ; Satler, Lowell F., MD ; Suddath, William O., MD ; Kent, Kenneth, MD, PhD ; Gurbel, Paul, MD ; Waksman, Ron, MD</creatorcontrib><description>Drug-eluting stent (DES) thrombosis has a multifactorial etiology. Variable responsiveness to antiplatelet therapy likely contributes to its pathogenesis. We aimed to determine whether patients who had experienced DES thrombosis compared with a cohort of patients who had not would exhibit greater platelet reactivity and a greater prevalence of aspirin and clopidogrel resistance. The effect of aspirin and clopidogrel on platelet reactivity was determined after angiographically proven DES thrombosis in 26 patients and in 21 patients who had not experienced stent thrombosis (ST) ≥18 months after DES implantation. Aspirin effect was assessed using the VerifyNow Aspirin Assay, and the effect of clopidogrel was assessed using the VerifyNow P2Y12 Assay and vasodilator-stimulated phosphoprotein phosphorylation (VASP-P). Aspirin resistance was present in 23% of patients with ST and 5% of controls (p = NS). Clopidogrel resistance was present in 40% of patients with ST and 14% of controls using the P2Y12 assay (p = 0.02) and 90% of patients with ST and 67% of controls using the VASP-P assay (p = NS). Mean aspirin reaction units were significantly greater among all patients with ST and those with early ST compared with controls (477 ± 89 vs 429 ± 58, p = 0.04; and 485 ± 84 vs 429 ± 58, p = 0.02, respectively). Mean P2Y12 reaction units were significantly greater among patients with early ST compared with controls (265 ± 102 vs 184 ± 76, p = 0.01). The results of the VASP-P assay did not correlate with the presence of ST. In conclusion, patients who experienced DES thrombosis demonstrated significantly greater rates of clopidogrel resistance as determined by P2Y12 reaction units, but not VASP-P, compared with patients without DES thrombosis. Aspirin reaction units were significantly greater in the DES thrombosis population. Point-of-care testing with the VerifyNow Aspirin and P2Y12 Assays has the potential to identify patients at increased risk of ST, particularly early ST, after DES deployment.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2009.04.015</identifier><identifier>PMID: 19660606</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Aspirin ; Aspirin - pharmacology ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular ; Case-Control Studies ; Cohort Studies ; Coronary Thrombosis - epidemiology ; Coronary Thrombosis - therapy ; Drug Resistance ; Drug therapy ; Drug-Eluting Stents ; Female ; Graft Occlusion, Vascular - epidemiology ; Graft Occlusion, Vascular - therapy ; Humans ; Male ; Medical sciences ; Middle Aged ; Patients ; Platelet Aggregation - drug effects ; Platelet Aggregation Inhibitors - pharmacology ; Prevalence ; Stents ; Thrombosis ; Ticlopidine - analogs & derivatives ; Ticlopidine - pharmacology ; Veins & arteries</subject><ispartof>The American journal of cardiology, 2009-08, Vol.104 (4), p.525-530</ispartof><rights>Elsevier Inc.</rights><rights>2009 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Aug 15, 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-77b25e1959db248c863d16ba26907b6acf7b4d961f716c6397c987ed0692667a3</citedby><cites>FETCH-LOGICAL-c475t-77b25e1959db248c863d16ba26907b6acf7b4d961f716c6397c987ed0692667a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914909009187$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21829092$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19660606$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pinto Slottow, Tina L., MD</creatorcontrib><creatorcontrib>Bonello, Laurent, MD</creatorcontrib><creatorcontrib>Gavini, Rekha, BS</creatorcontrib><creatorcontrib>Beauzile, Patricia, BS</creatorcontrib><creatorcontrib>Sushinsky, Steven J., BS</creatorcontrib><creatorcontrib>Scheinowitz, Mickey, PhD</creatorcontrib><creatorcontrib>Kaneshige, Kimberly, BS</creatorcontrib><creatorcontrib>Xue, Zhenyi, MS</creatorcontrib><creatorcontrib>Torguson, Rebecca, MPH</creatorcontrib><creatorcontrib>Tantry, Udaya, PhD</creatorcontrib><creatorcontrib>Pichard, Augusto D., MD</creatorcontrib><creatorcontrib>Satler, Lowell F., MD</creatorcontrib><creatorcontrib>Suddath, William O., MD</creatorcontrib><creatorcontrib>Kent, Kenneth, MD, PhD</creatorcontrib><creatorcontrib>Gurbel, Paul, MD</creatorcontrib><creatorcontrib>Waksman, Ron, MD</creatorcontrib><title>Prevalence of Aspirin and Clopidogrel Resistance Among Patients With and Without Drug-Eluting Stent Thrombosis</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Drug-eluting stent (DES) thrombosis has a multifactorial etiology. Variable responsiveness to antiplatelet therapy likely contributes to its pathogenesis. We aimed to determine whether patients who had experienced DES thrombosis compared with a cohort of patients who had not would exhibit greater platelet reactivity and a greater prevalence of aspirin and clopidogrel resistance. The effect of aspirin and clopidogrel on platelet reactivity was determined after angiographically proven DES thrombosis in 26 patients and in 21 patients who had not experienced stent thrombosis (ST) ≥18 months after DES implantation. Aspirin effect was assessed using the VerifyNow Aspirin Assay, and the effect of clopidogrel was assessed using the VerifyNow P2Y12 Assay and vasodilator-stimulated phosphoprotein phosphorylation (VASP-P). Aspirin resistance was present in 23% of patients with ST and 5% of controls (p = NS). Clopidogrel resistance was present in 40% of patients with ST and 14% of controls using the P2Y12 assay (p = 0.02) and 90% of patients with ST and 67% of controls using the VASP-P assay (p = NS). Mean aspirin reaction units were significantly greater among all patients with ST and those with early ST compared with controls (477 ± 89 vs 429 ± 58, p = 0.04; and 485 ± 84 vs 429 ± 58, p = 0.02, respectively). Mean P2Y12 reaction units were significantly greater among patients with early ST compared with controls (265 ± 102 vs 184 ± 76, p = 0.01). The results of the VASP-P assay did not correlate with the presence of ST. In conclusion, patients who experienced DES thrombosis demonstrated significantly greater rates of clopidogrel resistance as determined by P2Y12 reaction units, but not VASP-P, compared with patients without DES thrombosis. Aspirin reaction units were significantly greater in the DES thrombosis population. Point-of-care testing with the VerifyNow Aspirin and P2Y12 Assays has the potential to identify patients at increased risk of ST, particularly early ST, after DES deployment.</description><subject>Aged</subject><subject>Aspirin</subject><subject>Aspirin - pharmacology</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Case-Control Studies</subject><subject>Cohort Studies</subject><subject>Coronary Thrombosis - epidemiology</subject><subject>Coronary Thrombosis - therapy</subject><subject>Drug Resistance</subject><subject>Drug therapy</subject><subject>Drug-Eluting Stents</subject><subject>Female</subject><subject>Graft Occlusion, Vascular - epidemiology</subject><subject>Graft Occlusion, Vascular - therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Platelet Aggregation - drug effects</subject><subject>Platelet Aggregation Inhibitors - pharmacology</subject><subject>Prevalence</subject><subject>Stents</subject><subject>Thrombosis</subject><subject>Ticlopidine - analogs & derivatives</subject><subject>Ticlopidine - pharmacology</subject><subject>Veins & arteries</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFktFr1TAUxoMo7jr9E5Qi6FvrSdomzYtyuW4qDBxu4mNIk_QutW2uSTrYf7_UWybsRfKQBH7ny8n3HYReYygwYPqhL-TYK-l1QQB4AVUBuH6CNrhhPMccl0_RBgBIznHFT9CLEPp0xbimz9EJ5pRCWhs0XXpzKwczKZO5LtuGg_V2yuSks93gDla7vTdD9sMEG6JcqO3opn12KaM1UwzZLxtv_uLLwc0x--znfX42zNEm7ComKLu-8W5sXZJ4iZ51cgjm1bqfop_nZ9e7r_nF9y_fdtuLXFWsjjljLakN5jXXLaka1dBSY9pKQjmwlkrVsbbSnOKOYapoyZniDTMaKCeUMlmeovdH3YN3f2YTohhtUGYY5GTcHARldc2AVAl8-wjs3eyn1JsgJZSsIVAmqD5CyrsQvOnEwdtR-juBQSxpiF6saYglDQGVSGmkujer-NyORv-rWu1PwLsVkEHJofPJYRseOIIbwoGTxH06ciZ5dmuNF0HZJTNtvVFRaGf_28rHRwpqsJNNj_42dyY8fBqLQASIq2V0lskBnkTSTJX3wIm_Aw</recordid><startdate>20090815</startdate><enddate>20090815</enddate><creator>Pinto Slottow, Tina L., MD</creator><creator>Bonello, Laurent, MD</creator><creator>Gavini, Rekha, BS</creator><creator>Beauzile, Patricia, BS</creator><creator>Sushinsky, Steven J., BS</creator><creator>Scheinowitz, Mickey, PhD</creator><creator>Kaneshige, Kimberly, BS</creator><creator>Xue, Zhenyi, MS</creator><creator>Torguson, Rebecca, MPH</creator><creator>Tantry, Udaya, PhD</creator><creator>Pichard, Augusto D., MD</creator><creator>Satler, Lowell F., MD</creator><creator>Suddath, William O., MD</creator><creator>Kent, Kenneth, MD, PhD</creator><creator>Gurbel, Paul, MD</creator><creator>Waksman, Ron, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20090815</creationdate><title>Prevalence of Aspirin and Clopidogrel Resistance Among Patients With and Without Drug-Eluting Stent Thrombosis</title><author>Pinto Slottow, Tina L., MD ; Bonello, Laurent, MD ; Gavini, Rekha, BS ; Beauzile, Patricia, BS ; Sushinsky, Steven J., BS ; Scheinowitz, Mickey, PhD ; Kaneshige, Kimberly, BS ; Xue, Zhenyi, MS ; Torguson, Rebecca, MPH ; Tantry, Udaya, PhD ; Pichard, Augusto D., MD ; Satler, Lowell F., MD ; Suddath, William O., MD ; Kent, Kenneth, MD, PhD ; Gurbel, Paul, MD ; Waksman, Ron, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-77b25e1959db248c863d16ba26907b6acf7b4d961f716c6397c987ed0692667a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aspirin</topic><topic>Aspirin - pharmacology</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Case-Control Studies</topic><topic>Cohort Studies</topic><topic>Coronary Thrombosis - epidemiology</topic><topic>Coronary Thrombosis - therapy</topic><topic>Drug Resistance</topic><topic>Drug therapy</topic><topic>Drug-Eluting Stents</topic><topic>Female</topic><topic>Graft Occlusion, Vascular - epidemiology</topic><topic>Graft Occlusion, Vascular - therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Platelet Aggregation - drug effects</topic><topic>Platelet Aggregation Inhibitors - pharmacology</topic><topic>Prevalence</topic><topic>Stents</topic><topic>Thrombosis</topic><topic>Ticlopidine - analogs & derivatives</topic><topic>Ticlopidine - pharmacology</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pinto Slottow, Tina L., MD</creatorcontrib><creatorcontrib>Bonello, Laurent, MD</creatorcontrib><creatorcontrib>Gavini, Rekha, BS</creatorcontrib><creatorcontrib>Beauzile, Patricia, BS</creatorcontrib><creatorcontrib>Sushinsky, Steven J., BS</creatorcontrib><creatorcontrib>Scheinowitz, Mickey, PhD</creatorcontrib><creatorcontrib>Kaneshige, Kimberly, BS</creatorcontrib><creatorcontrib>Xue, Zhenyi, MS</creatorcontrib><creatorcontrib>Torguson, Rebecca, MPH</creatorcontrib><creatorcontrib>Tantry, Udaya, PhD</creatorcontrib><creatorcontrib>Pichard, Augusto D., MD</creatorcontrib><creatorcontrib>Satler, Lowell F., MD</creatorcontrib><creatorcontrib>Suddath, William O., MD</creatorcontrib><creatorcontrib>Kent, Kenneth, MD, PhD</creatorcontrib><creatorcontrib>Gurbel, Paul, MD</creatorcontrib><creatorcontrib>Waksman, Ron, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pinto Slottow, Tina L., MD</au><au>Bonello, Laurent, MD</au><au>Gavini, Rekha, BS</au><au>Beauzile, Patricia, BS</au><au>Sushinsky, Steven J., BS</au><au>Scheinowitz, Mickey, PhD</au><au>Kaneshige, Kimberly, BS</au><au>Xue, Zhenyi, MS</au><au>Torguson, Rebecca, MPH</au><au>Tantry, Udaya, PhD</au><au>Pichard, Augusto D., MD</au><au>Satler, Lowell F., MD</au><au>Suddath, William O., MD</au><au>Kent, Kenneth, MD, PhD</au><au>Gurbel, Paul, MD</au><au>Waksman, Ron, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of Aspirin and Clopidogrel Resistance Among Patients With and Without Drug-Eluting Stent Thrombosis</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2009-08-15</date><risdate>2009</risdate><volume>104</volume><issue>4</issue><spage>525</spage><epage>530</epage><pages>525-530</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Drug-eluting stent (DES) thrombosis has a multifactorial etiology. Variable responsiveness to antiplatelet therapy likely contributes to its pathogenesis. We aimed to determine whether patients who had experienced DES thrombosis compared with a cohort of patients who had not would exhibit greater platelet reactivity and a greater prevalence of aspirin and clopidogrel resistance. The effect of aspirin and clopidogrel on platelet reactivity was determined after angiographically proven DES thrombosis in 26 patients and in 21 patients who had not experienced stent thrombosis (ST) ≥18 months after DES implantation. Aspirin effect was assessed using the VerifyNow Aspirin Assay, and the effect of clopidogrel was assessed using the VerifyNow P2Y12 Assay and vasodilator-stimulated phosphoprotein phosphorylation (VASP-P). Aspirin resistance was present in 23% of patients with ST and 5% of controls (p = NS). Clopidogrel resistance was present in 40% of patients with ST and 14% of controls using the P2Y12 assay (p = 0.02) and 90% of patients with ST and 67% of controls using the VASP-P assay (p = NS). Mean aspirin reaction units were significantly greater among all patients with ST and those with early ST compared with controls (477 ± 89 vs 429 ± 58, p = 0.04; and 485 ± 84 vs 429 ± 58, p = 0.02, respectively). Mean P2Y12 reaction units were significantly greater among patients with early ST compared with controls (265 ± 102 vs 184 ± 76, p = 0.01). The results of the VASP-P assay did not correlate with the presence of ST. In conclusion, patients who experienced DES thrombosis demonstrated significantly greater rates of clopidogrel resistance as determined by P2Y12 reaction units, but not VASP-P, compared with patients without DES thrombosis. Aspirin reaction units were significantly greater in the DES thrombosis population. Point-of-care testing with the VerifyNow Aspirin and P2Y12 Assays has the potential to identify patients at increased risk of ST, particularly early ST, after DES deployment.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19660606</pmid><doi>10.1016/j.amjcard.2009.04.015</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9149 |
| ispartof | The American journal of cardiology, 2009-08, Vol.104 (4), p.525-530 |
| issn | 0002-9149 1879-1913 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67557024 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Aged Aspirin Aspirin - pharmacology Biological and medical sciences Cardiology. Vascular system Cardiovascular Case-Control Studies Cohort Studies Coronary Thrombosis - epidemiology Coronary Thrombosis - therapy Drug Resistance Drug therapy Drug-Eluting Stents Female Graft Occlusion, Vascular - epidemiology Graft Occlusion, Vascular - therapy Humans Male Medical sciences Middle Aged Patients Platelet Aggregation - drug effects Platelet Aggregation Inhibitors - pharmacology Prevalence Stents Thrombosis Ticlopidine - analogs & derivatives Ticlopidine - pharmacology Veins & arteries |
| title | Prevalence of Aspirin and Clopidogrel Resistance Among Patients With and Without Drug-Eluting Stent Thrombosis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T18%3A38%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence%20of%20Aspirin%20and%20Clopidogrel%20Resistance%20Among%20Patients%20With%20and%20Without%20Drug-Eluting%20Stent%20Thrombosis&rft.jtitle=The%20American%20journal%20of%20cardiology&rft.au=Pinto%20Slottow,%20Tina%20L.,%20MD&rft.date=2009-08-15&rft.volume=104&rft.issue=4&rft.spage=525&rft.epage=530&rft.pages=525-530&rft.issn=0002-9149&rft.eissn=1879-1913&rft.coden=AJCDAG&rft_id=info:doi/10.1016/j.amjcard.2009.04.015&rft_dat=%3Cproquest_cross%3E1825957621%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=230378203&rft_id=info:pmid/19660606&rft_els_id=1_s2_0_S0002914909009187&rfr_iscdi=true |