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Adjusted Clopidogrel Loading Doses According to Vasodilator-Stimulated Phosphoprotein Phosphorylation Index Decrease Rate of Major Adverse Cardiovascular Events in Patients With Clopidogrel Resistance

A Multicenter Randomized Prospective Study

Laurent Bonello, MD^_*,_*, Laurence Camoin-Jau, MD, PhD, Stéphane Arques, MD, Christian Boyer, MD, Dimitri Panagides, MD, PhD^||, Olivier Wittenberg, MD^¶, Marie-Claude Simeoni, MD^#, Paul Barragan, MD^_**, Françoise Dignat-George, MD, PhD and Franck Paganelli, MD, PhD^_*

^_* Service de Cardiologie, Hôpital Universitaire Nord, Marseille, France
Laboratoire d'Hématologie, Unité INSERM UMRS 608, Hôpital de la Conception, Marseille, France
Service de Cardiologie, Hôpital d'Aubagne, Aubagne, France
Service de Cardiologie, Clinique Clairval, Marseille, France
^|| Service de Cardiologie, Clinique Bouchard, Marseille, France
^¶ Service de Cardiologie, Hôpital Privé Beauregard, Marseille, France
^# Laboratoire de Statistique, Faculté de la Timone, Marseille, France
^_** Service de Cardiologie, Polyclinique les Fleurs, Ollioules, France

View larger version (36K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Study Design VASP = vasodilator-stimulated phosphoprotein.

View larger version (16K): [in this window] [in a new window] [Download PPT slide]   Figure 2 Effects of Each Additional Bolus of Clopidogrel on the VASP Index in the VASP-Guided Group VASP 1 is the VASP index after the initial loading dose as given to patients in both groups; VASP 2 is that after the second loading dose, and so on. Abbreviation as in Figure 1.

View larger version (17K): [in this window] [in a new window] [Download PPT slide]   Figure 3 Kaplan-Meier Analysis for 30-Day MACE Kaplan-Meier analysis for 30-day major adverse cardiovascular (CV) events (MACE) according to group. Log-rank = 7.75, p < 0.005. Blue = control group; red = VASP-guided group. Abbreviation as in Figure 1.