Elevated Plasma Fibrinogen and Diabetes Mellitus Are Associated With Lower Inhibition of Platelet Reactivity With Clopidogrel

Elevated Plasma Fibrinogen and Diabetes Mellitus Are Associated With Lower Inhibition of Platelet Reactivity With Clopidogrel Lawrence Ang, Vachaspathi Palakodeti, Ahmer Khalid, Sotirios Tsimikas, Zaheib Idrees, Phillip Tran, Paul Clopton, Nayab Zafar, Guilherme Bromberg-Marin, Shahin Keramati, Ehtisham Mahmud A heterogeneous platelet reactivity response to clopidogrel exists. In this study, platelet reactivity was measured in 157 subjects (age 67.2 ± 12.2 years; 59.9% men) with cardiovascular disease utilizing a rapid platelet function assay. Among variables known to affect platelet reactivity, elevated plasma fibrinogen (≥375 mg/dl), diabetes mellitus, and increased body mass index (BMI) (≥25 kg/m2 ) were associated with lower platelet inhibition (PI) with clopidogrel. After testing for interaction, significantly lower PI was observed only in diabetic patients with elevated plasma fibrinogen (≥375 mg/dl) while increased BMI (≥25 kg/m2 ) remained independently associated with lower PI regardless of diabetic status or fibrinogen level.