Stent Thrombosis Is Associated With an Impaired Response to Antiplatelet Therapy
We sought to evaluate the response to antiplatelet therapy in patients with stent thrombosis (ST). Stent thrombosis is associated with considerable morbidity and mortality. An impaired response to antiplatelet therapy might be related to an increased risk for ST. Eighty-two patients were included in...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2005-06, Vol.45 (11), p.1748-1752 |
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| container_title | Journal of the American College of Cardiology |
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| creator | Wenaweser, Peter Dörffler-Melly, Janine Imboden, Katja Windecker, Stephan Togni, Mario Meier, Bernhard Haeberli, Andre Hess, Otto M. |
| description | We sought to evaluate the response to antiplatelet therapy in patients with stent thrombosis (ST).
Stent thrombosis is associated with considerable morbidity and mortality. An impaired response to antiplatelet therapy might be related to an increased risk for ST.
Eighty-two patients were included in the present study: 23 patients with previous ST, 50 matched controls (coronary stenting without ST), and 9 healthy volunteers. Platelet aggregation (PA) was studied (optical aggregometry) under monotherapy with acetylsalicylic acid (ASA) 100 mg daily for one month, followed by dual therapy with ASA 100 mg and clopidogrel 75 mg daily (loading dose 300 mg) for another month.
Maximal (5 and 20 μmol) adenosine diphosphate-induced PA was significantly higher in patients with ST compared with controls (5 μmol, p < 0.005; 20 μmol, p < 0.05) and volunteers (5 μmol, p < 0.005; 20 μmol, p < 0.05). Resistance to ASA (>20% aggregation with 0.5 mg/ml arachidonic acid) was more prevalent in patients with ST (48%) compared with control patients (32%, p = ns) and volunteers (0%, p = 0.01). Clopidogrel significantly reduced PA in all three groups, but intergroup differences persisted. Clopidogrel resistance ( |
| doi_str_mv | 10.1016/j.jacc.2005.01.058 |
| format | Article |
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Stent thrombosis is associated with considerable morbidity and mortality. An impaired response to antiplatelet therapy might be related to an increased risk for ST.
Eighty-two patients were included in the present study: 23 patients with previous ST, 50 matched controls (coronary stenting without ST), and 9 healthy volunteers. Platelet aggregation (PA) was studied (optical aggregometry) under monotherapy with acetylsalicylic acid (ASA) 100 mg daily for one month, followed by dual therapy with ASA 100 mg and clopidogrel 75 mg daily (loading dose 300 mg) for another month.
Maximal (5 and 20 μmol) adenosine diphosphate-induced PA was significantly higher in patients with ST compared with controls (5 μmol, p < 0.005; 20 μmol, p < 0.05) and volunteers (5 μmol, p < 0.005; 20 μmol, p < 0.05). Resistance to ASA (>20% aggregation with 0.5 mg/ml arachidonic acid) was more prevalent in patients with ST (48%) compared with control patients (32%, p = ns) and volunteers (0%, p = 0.01). Clopidogrel significantly reduced PA in all three groups, but intergroup differences persisted. Clopidogrel resistance (<10% relative change) was similar in patients with ST, control patients, and volunteers (4%, 6%, and 11%, respectively, all p = NS). However, combined ASA and clopidogrel resistance was more prevalent in patients with ST (52%) compared with controls (38%, p = NS) and volunteers (11%, p < 0.05).
Patients with previous ST show an impaired response to antiplatelet therapy with ASA compared with controls and volunteers. Additional treatment with clopidogrel is not able to overcome these differences in PA. Acetylsalicylic acid but not clopidogrel resistance appears to be associated with ST.]]></description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2005.01.058</identifier><identifier>PMID: 15936599</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angioplasty, Balloon, Coronary ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Coronary Disease - therapy ; Coronary vessels ; Drug therapy ; Drug Therapy, Combination ; Female ; Heart attacks ; Humans ; Male ; Medical sciences ; Middle Aged ; Platelet Aggregation - drug effects ; Platelet Aggregation Inhibitors - administration & dosage ; Retrospective Studies ; Stents ; Stents - adverse effects ; Thrombosis - etiology ; Thrombosis - physiopathology ; Thrombosis - prevention & control ; Ticlopidine - administration & dosage ; Ticlopidine - analogs & derivatives</subject><ispartof>Journal of the American College of Cardiology, 2005-06, Vol.45 (11), p.1748-1752</ispartof><rights>2005 American College of Cardiology Foundation</rights><rights>2005 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jun 7, 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c492t-5cf4dddfa02cd6ec6879c56727c8c8ddb387e2e7a535997a745ad0be88cb38683</citedby><cites>FETCH-LOGICAL-c492t-5cf4dddfa02cd6ec6879c56727c8c8ddb387e2e7a535997a745ad0be88cb38683</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jacc.2005.01.058$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16930551$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15936599$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wenaweser, Peter</creatorcontrib><creatorcontrib>Dörffler-Melly, Janine</creatorcontrib><creatorcontrib>Imboden, Katja</creatorcontrib><creatorcontrib>Windecker, Stephan</creatorcontrib><creatorcontrib>Togni, Mario</creatorcontrib><creatorcontrib>Meier, Bernhard</creatorcontrib><creatorcontrib>Haeberli, Andre</creatorcontrib><creatorcontrib>Hess, Otto M.</creatorcontrib><title>Stent Thrombosis Is Associated With an Impaired Response to Antiplatelet Therapy</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description><![CDATA[We sought to evaluate the response to antiplatelet therapy in patients with stent thrombosis (ST).
Stent thrombosis is associated with considerable morbidity and mortality. An impaired response to antiplatelet therapy might be related to an increased risk for ST.
Eighty-two patients were included in the present study: 23 patients with previous ST, 50 matched controls (coronary stenting without ST), and 9 healthy volunteers. Platelet aggregation (PA) was studied (optical aggregometry) under monotherapy with acetylsalicylic acid (ASA) 100 mg daily for one month, followed by dual therapy with ASA 100 mg and clopidogrel 75 mg daily (loading dose 300 mg) for another month.
Maximal (5 and 20 μmol) adenosine diphosphate-induced PA was significantly higher in patients with ST compared with controls (5 μmol, p < 0.005; 20 μmol, p < 0.05) and volunteers (5 μmol, p < 0.005; 20 μmol, p < 0.05). Resistance to ASA (>20% aggregation with 0.5 mg/ml arachidonic acid) was more prevalent in patients with ST (48%) compared with control patients (32%, p = ns) and volunteers (0%, p = 0.01). Clopidogrel significantly reduced PA in all three groups, but intergroup differences persisted. Clopidogrel resistance (<10% relative change) was similar in patients with ST, control patients, and volunteers (4%, 6%, and 11%, respectively, all p = NS). However, combined ASA and clopidogrel resistance was more prevalent in patients with ST (52%) compared with controls (38%, p = NS) and volunteers (11%, p < 0.05).
Patients with previous ST show an impaired response to antiplatelet therapy with ASA compared with controls and volunteers. Additional treatment with clopidogrel is not able to overcome these differences in PA. Acetylsalicylic acid but not clopidogrel resistance appears to be associated with ST.]]></description><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Disease - therapy</subject><subject>Coronary vessels</subject><subject>Drug therapy</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Platelet Aggregation - drug effects</subject><subject>Platelet Aggregation Inhibitors - administration & dosage</subject><subject>Retrospective Studies</subject><subject>Stents</subject><subject>Stents - adverse effects</subject><subject>Thrombosis - etiology</subject><subject>Thrombosis - physiopathology</subject><subject>Thrombosis - prevention & control</subject><subject>Ticlopidine - administration & dosage</subject><subject>Ticlopidine - analogs & derivatives</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1r3DAQhkVpaDZp_0APxVDam13Jtr6glyW06UIgoU3pUWhHYyJjW67kDeTfV2YXAj3kNKB55uXVQ8h7RitGmfjSV70FqGpKeUVZRbl6RTaMc1U2XMvXZENlw0tGtTwnFyn1lFKhmH5DzhnXjeBab8jdrwWnpbh_iGHch-RTsUvFNqUA3i7oij9-eSjsVOzG2fqYH35imsOUsFhCsZ0WPw-ZG3CNwGjnp7fkrLNDwneneUl-f_92f_WjvLm93l1tb0podb2UHLrWOddZWoMTCEJJDVzIWoIC5dy-URJrlJbnv2hpZcuto3tUCvJKqOaSfD7mzjH8PWBazOgT4DDYCcMhGSGV1q1kGfz4H9iHQ5xyN8M4FUy0DW8yVR8piCGliJ2Zox9tfDKMmtW26c1q26y2DWUm285HH07Rh_2I7vnkpDcDn06ATWCHLtoJfHrmhG4o52vHr0cOs7FHj9Ek8DgBuuwcFuOCf6nHPxCPnRk</recordid><startdate>20050607</startdate><enddate>20050607</enddate><creator>Wenaweser, Peter</creator><creator>Dörffler-Melly, Janine</creator><creator>Imboden, Katja</creator><creator>Windecker, Stephan</creator><creator>Togni, Mario</creator><creator>Meier, Bernhard</creator><creator>Haeberli, Andre</creator><creator>Hess, Otto M.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><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>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20050607</creationdate><title>Stent Thrombosis Is Associated With an Impaired Response to Antiplatelet Therapy</title><author>Wenaweser, Peter ; Dörffler-Melly, Janine ; Imboden, Katja ; Windecker, Stephan ; Togni, Mario ; Meier, Bernhard ; Haeberli, Andre ; Hess, Otto M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c492t-5cf4dddfa02cd6ec6879c56727c8c8ddb387e2e7a535997a745ad0be88cb38683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Disease - therapy</topic><topic>Coronary vessels</topic><topic>Drug therapy</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Platelet Aggregation - drug effects</topic><topic>Platelet Aggregation Inhibitors - administration & dosage</topic><topic>Retrospective Studies</topic><topic>Stents</topic><topic>Stents - adverse effects</topic><topic>Thrombosis - etiology</topic><topic>Thrombosis - physiopathology</topic><topic>Thrombosis - prevention & control</topic><topic>Ticlopidine - administration & dosage</topic><topic>Ticlopidine - analogs & derivatives</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wenaweser, Peter</creatorcontrib><creatorcontrib>Dörffler-Melly, Janine</creatorcontrib><creatorcontrib>Imboden, Katja</creatorcontrib><creatorcontrib>Windecker, Stephan</creatorcontrib><creatorcontrib>Togni, Mario</creatorcontrib><creatorcontrib>Meier, Bernhard</creatorcontrib><creatorcontrib>Haeberli, Andre</creatorcontrib><creatorcontrib>Hess, Otto M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><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>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wenaweser, Peter</au><au>Dörffler-Melly, Janine</au><au>Imboden, Katja</au><au>Windecker, Stephan</au><au>Togni, Mario</au><au>Meier, Bernhard</au><au>Haeberli, Andre</au><au>Hess, Otto M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stent Thrombosis Is Associated With an Impaired Response to Antiplatelet Therapy</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2005-06-07</date><risdate>2005</risdate><volume>45</volume><issue>11</issue><spage>1748</spage><epage>1752</epage><pages>1748-1752</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract><![CDATA[We sought to evaluate the response to antiplatelet therapy in patients with stent thrombosis (ST).
Stent thrombosis is associated with considerable morbidity and mortality. An impaired response to antiplatelet therapy might be related to an increased risk for ST.
Eighty-two patients were included in the present study: 23 patients with previous ST, 50 matched controls (coronary stenting without ST), and 9 healthy volunteers. Platelet aggregation (PA) was studied (optical aggregometry) under monotherapy with acetylsalicylic acid (ASA) 100 mg daily for one month, followed by dual therapy with ASA 100 mg and clopidogrel 75 mg daily (loading dose 300 mg) for another month.
Maximal (5 and 20 μmol) adenosine diphosphate-induced PA was significantly higher in patients with ST compared with controls (5 μmol, p < 0.005; 20 μmol, p < 0.05) and volunteers (5 μmol, p < 0.005; 20 μmol, p < 0.05). Resistance to ASA (>20% aggregation with 0.5 mg/ml arachidonic acid) was more prevalent in patients with ST (48%) compared with control patients (32%, p = ns) and volunteers (0%, p = 0.01). Clopidogrel significantly reduced PA in all three groups, but intergroup differences persisted. Clopidogrel resistance (<10% relative change) was similar in patients with ST, control patients, and volunteers (4%, 6%, and 11%, respectively, all p = NS). However, combined ASA and clopidogrel resistance was more prevalent in patients with ST (52%) compared with controls (38%, p = NS) and volunteers (11%, p < 0.05).
Patients with previous ST show an impaired response to antiplatelet therapy with ASA compared with controls and volunteers. Additional treatment with clopidogrel is not able to overcome these differences in PA. Acetylsalicylic acid but not clopidogrel resistance appears to be associated with ST.]]></abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15936599</pmid><doi>10.1016/j.jacc.2005.01.058</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Angioplasty, Balloon, Coronary Biological and medical sciences Cardiology Cardiology. Vascular system Coronary Disease - therapy Coronary vessels Drug therapy Drug Therapy, Combination Female Heart attacks Humans Male Medical sciences Middle Aged Platelet Aggregation - drug effects Platelet Aggregation Inhibitors - administration & dosage Retrospective Studies Stents Stents - adverse effects Thrombosis - etiology Thrombosis - physiopathology Thrombosis - prevention & control Ticlopidine - administration & dosage Ticlopidine - analogs & derivatives |
| title | Stent Thrombosis Is Associated With an Impaired Response to Antiplatelet Therapy |
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