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Stent Thrombosis Is Associated With an Impaired Response to Antiplatelet Therapy

Peter Wenaweser, MD^_*, Janine Dörffler-Melly, MD, PhD, Katja Imboden, BA^_*, Stephan Windecker, MD^_*, Mario Togni, MD^_*, Bernhard Meier, MD^_*, Andre Haeberli, MD and Otto M. Hess, MD^_*,_*

^_* Department of Cardiology, Swiss Cardiovascular Center, University Hospital, Bern, Switzerland
Department of Angiology, Swiss Cardiovascular Center, University Hospital, Bern, Switzerland
Department of Clinical Research, Swiss Cardiovascular Center, University Hospital, Bern, Switzerland

View larger version (14K): [in a new window]   Figure 1 Platelet aggregation (top: 5 µmol adenosine diphosphate [ADP]; middle: 20 µmol ADP) in patients with stent thrombosis (ST), control patients, and volunteers. Black boxes = acetylsalicyclic acid (ASA) (100 mg daily) alone; white boxes = ASA plus clopidogrel (75 mg daily). Platelet aggregation (bottom: 0.5 mg/ml arachionic acid) on ASA (100 mg daily) in patients with ST, control patients, and volunteers.

View larger version (16K): [in a new window]   Figure 2 Resistance to acetylsalicyclic acid (ASA) (top: 0.5 mg/ml arachionic acid, defined as 20% maximal platelet aggregation). Clopidogrel resistance (middle: 5 µmol/l adenosine diphosphate, defined as relative change between aggregation under ASA and ASA plus clopidogrel <10%). Acetylsalicyclic acid and/or clopidogrel resistance (bottom: combined results of the top and middle panels). ns = not significant; ST = stent thrombosis.