The Significance of Clopidogrel Low-Responsiveness on Stent Thrombosis and Cardiac Death Assessed by the Verifynow P2Y12 Assay in Patients With Acute Coronary Syndrome Within 6 Months After Drug-Eluting Stent Implantation.
10.4070/kcj.2009.39.12.512
- Author:
Kyounghoon LEE
1
;
Seung Whan LEE
;
Jun Won LEE
;
Seong Yoon KIM
;
Young Jin YOUN
;
Min Soo AHN
;
Jang Young KIM
;
Byung Su YOO
;
Junghan YOON
;
Kyung Hoon CHOE
Author Information
1. Division of Cardiology, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea.
- Publication Type:Original Article
- Keywords:
Thienopyridine;
Platelets;
Clopidogrel;
Thrombosis;
Stents
- MeSH:
Acute Coronary Syndrome;
Blood Platelets;
Death;
Drug-Eluting Stents;
Humans;
Logistic Models;
Male;
Odds Ratio;
Prospective Studies;
Pyridines;
Stents;
Thrombosis;
Ticlopidine
- From:Korean Circulation Journal
2009;39(12):512-518
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Clopidogrel resistance or low-responsiveness may be associated with recurrent atherothrombotic events after drug-eluting stent (DES) implantation. We prospectively evaluated the association between clopidogrel resistance assessed by the Verifynow(TM) P2Y12 assay (Accumetrics, San Diego, CA, USA) and stent thrombosis (ST) or cardiac death (CD) in patients with acute coronary syndrome (ACS) within 6 months after DES implantation. SUBJECTS AND METHODS: We enrolled 237 consecutive patients (160 males, 65.2+/-10.3 years) with ACS who received a DES implantation. The composite endpoint was defined to CD or ST by Academic Research Consortium definitions within 6 months post-implantation. Clopidogrel resistance was defined as <20% inhibition of the P2Y12 receptor. RESULTS: Baseline demographic characteristics were similar between 142 normal individuals and 95 clopidogrel resistant patients. CD occurred in one case (0.7%) in the normal group and two cases (2.13%) in the resistant group (p=0.344). There was no episode of ST in the normal group and four episodes in the resistant group (4.2%, four definite ST) (p=0.035). Univariate logistic regression revealed an adjusted odds ratio (OR) for composite end point of CD or ST of 9.646 {95% confidence interval (CI) 1.139-81.679}, and multivariate logistic regression for composite end point revealed an OR of 12.074 (95% CI 1.205-120.992). CONCLUSION: Clopidogrel low-responsiveness assessed by the Verifynow(TM) P2Y12 assay is an independent predictor of ST and composite end point of ST or CD in patients with ACS within 6 months after DES implantation.
