CLINICAL RESEARCH: INTERVENTIONAL CARDIOLOGY
Impact of the Degree of Peri-Interventional Platelet Inhibition After Loading With Clopidogrel on Early Clinical Outcome of Elective Coronary Stent Placement
Willibald Hochholzer, MD*,
Dietmar Trenk, PhD*,
Hans-Peter Bestehorn, MD*,
Benjamin Fischer*,
Christian M. Valina, MD*,
Miroslaw Ferenc, MD*,
Michael Gick, MD*,
Angelika Caputo, PhD ,
Heinz Joachim Büttner, MD* and
Franz-Josef Neumann, MD*,*
* Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany
Institut für Medizinische Biometrie und Medizinische Informatik, University of Freiburg, Freiburg, Germany.
Manuscript received December 8, 2005;
revised manuscript received May 30, 2006,
accepted June 6, 2006.
* Reprint requests and correspondence:
Dr. Franz-Josef Neumann, Herz-Zentrum Bad Krozingen, Suedring 15, 79189 Bad Krozingen, Germany. (Email: franz-josef.neumann{at}herzzentrum.de).
OBJECTIVES: Our prospective study tested the hypothesis that the 30-day clinical outcome of elective percutaneous catheter intervention (PCI) differs between strata defined by quartiles of platelet aggregation after loading with 600 mg clopidogrel.
BACKGROUND: Platelet responses after loading with clopidogrel are highly variable. The impact of this variability on the peri-interventional risk of patients undergoing PCI has not been investigated prospectively.
METHODS: Our study included 802 consecutive patients undergoing elective coronary stent placement. Before PCI, patients received a loading dose of 600 mg clopidogrel followed by 75 mg daily. Primary end point was the 30-day composite of death, myocardial infarction, and target lesion revascularization (major adverse cardiac events [MACE]). Platelet aggregation was assessed immediately before PCI by optical aggregometry (5 µmol/l adenosine diphosphate).
RESULTS: During 30-day follow-up, 15 patients (1.9%) incurred MACE (3 deaths, 8 myocardial infarctions, 8 target lesion revascularizations). Quartiles of platelet aggregation were <4%, 4% to 14%, 15% to 32%, and >32%. Thirty-day MACE differed significantly (p = 0.034) between quartiles of platelet aggregation. It was 0.5% in the first quartile, 0.5% in the second, 3.1% in the third, and 3.5% in the fourth. Platelet aggregation above the median carried a 6.7-fold risk (95% confidence interval 1.52 to 29.41; p = 0.003) of 30-day MACE. Multivariable logistic regression analysis, including pertinent covariables, confirmed platelet aggregation as a significant independent predictor of 30-day MACE (adjusted odds ratio per 10% increase in platelet aggregation 1.32, 95% confidence interval 1.04 to 1.61; p = 0.026).
CONCLUSIONS: The level of platelet aggregation immediately before elective coronary stenting in patients pre-treated with a high loading dose of clopidogrel is correlated with early outcome after the procedure.
|
Abbreviations and Acronyms
| | ADP = adenosine diphosphate | | AHA/ACC = American Heart Association/American College of Cardiology | | EXCELSIOR = Impact of Extent of Clopidogrel-Induced Platelet Inhibition During Elective Stent Implantation on Clinical Event Rate | | GP = glycoprotein | | MACE = major adverse cardiac event | | MI = myocardial infarction | | PCI = percutaneous catheter intervention | | TIMI = Thrombolysis In Myocardial Infarction |
|
Related Articles
-
Inside This Issue of JACC
J. Am. Coll. Cardiol. 2006 48: A41-A42.
[Full Text]
[PDF]
-
Platelet Function Assessment to Predict Outcomes After Coronary Interventions: Hype or Hope?
- Fernando Alfonso and Dominick J. Angiolillo
J. Am. Coll. Cardiol. 2006 48: 1751-1754.
[Full Text]
[PDF]
This article has been cited by other articles:

|
 |

|
 |
 
T. M. Leslie-Mazwi, R. V. Chandra, D. C. Oh, and R. G. Nogueira
Novel use of prasugrel for intracranial stent thrombosis
JNIS,
December 1, 2011;
3(4):
358 - 360.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. M. deGoma, G. Rivera, S. M. Lilly, M. H. U. Usman, and E. R. Mohler III
Personalized vascular medicine: Individualizing drug therapy
Vascular Medicine,
October 1, 2011;
16(5):
391 - 404.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
J.-S. Hulot, J.-P. Collet, G. Cayla, J. Silvain, F. Allanic, A. Bellemain-Appaix, S. A. Scott, and G. Montalescot
CYP2C19 But Not PON1 Genetic Variants Influence Clopidogrel Pharmacokinetics, Pharmacodynamics, and Clinical Efficacy in Post-Myocardial Infarction Patients
Circ Cardiovasc Interv,
October 1, 2011;
4(5):
422 - 428.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. J. Price, D. J. Angiolillo, P. S. Teirstein, E. Lillie, S. V. Manoukian, P. B. Berger, J.-F. Tanguay, C. P. Cannon, and E. J. Topol
Platelet Reactivity and Cardiovascular Outcomes After Percutaneous Coronary Intervention: A Time-Dependent Analysis of the Gauging Responsiveness With a VerifyNow P2Y12 Assay: Impact on Thrombosis and Safety (GRAVITAS) Trial
Circulation,
September 6, 2011;
124(10):
1132 - 1137.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Trenk, W. Hochholzer, M. F. Fromm, O. Zolk, C. M. Valina, C. Stratz, and F.-J. Neumann
Paraoxonase-1 Q192R Polymorphism and Antiplatelet Effects of Clopidogrel in Patients Undergoing Elective Coronary Stent Placement
Circ Cardiovasc Genet,
August 1, 2011;
4(4):
429 - 436.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. J. Breet, J. W. van Werkum, H. J. Bouman, J. C. Kelder, A. M. Harmsze, C. M. Hackeng, and J. M. ten Berg
High on-treatment platelet reactivity to both aspirin and clopidogrel is associated with the highest risk of adverse events following percutaneous coronary intervention
Heart,
June 15, 2011;
97(12):
983 - 990.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
W. Hochholzer, S. D. Wiviott, E. M. Antman, C. F. Contant, J. Guo, R. P. Giugliano, A. J. Dalby, G. Montalescot, and E. Braunwald
Predictors of Bleeding and Time Dependence of Association of Bleeding With Mortality: Insights From the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel--Thrombolysis in Myocardial Infarction 38 (TRITON-TIMI 38)
Circulation,
June 14, 2011;
123(23):
2681 - 2689.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Drazin, A. Choulakian, M. Nuno, P. Kornbluth, and M. J. Alexander
Body weight: a risk factor for subtherapeutic antithrombotic therapy in neurovascular stenting
JNIS,
June 1, 2011;
3(2):
177 - 181.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Htun, S. Fateh-Moghadam, C. Bischofs, W. Banya, K. Muller, B. Bigalke, K. Stellos, A. E. May, M. Flather, M. Gawaz, et al.
Low Responsiveness to Clopidogrel Increases Risk among CKD Patients Undergoing Coronary Intervention
J. Am. Soc. Nephrol.,
April 1, 2011;
22(4):
627 - 633.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. J. Price, P. B. Berger, P. S. Teirstein, J.-F. Tanguay, D. J. Angiolillo, D. Spriggs, S. Puri, M. Robbins, K. N. Garratt, O. F. Bertrand, et al.
Standard- vs High-Dose Clopidogrel Based on Platelet Function Testing After Percutaneous Coronary Intervention: The GRAVITAS Randomized Trial
JAMA,
March 16, 2011;
305(11):
1097 - 1105.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. Patti, D. Grieco, G. Dicuonzo, V. Pasceri, A. Nusca, and G. Di Sciascio
High Versus Standard Clopidogrel Maintenance Dose After Percutaneous Coronary Intervention and Effects on Platelet Inhibition, Endothelial Function, and Inflammation: Results of the ARMYDA-150 mg (Antiplatelet Therapy for Reduction of Myocardial Damage During Angioplasty) Randomized Study
J. Am. Coll. Cardiol.,
February 15, 2011;
57(7):
771 - 778.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. M. Goodwin, A. R. Desilets, and K. C. Willett
Thienopyridines in Acute Coronary Syndrome
Ann. Pharmacother.,
February 1, 2011;
45(2):
207 - 217.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
O. Morel, S. El Ghannudi, L. Jesel, B. Radulescu, N. Meyer, M.-L. Wiesel, S. Caillard, U. Campia, B. Moulin, C. Gachet, et al.
Cardiovascular Mortality in Chronic Kidney Disease Patients Undergoing Percutaneous Coronary Intervention Is Mainly Related to Impaired P2Y12 Inhibition by Clopidogrel
J. Am. Coll. Cardiol.,
January 25, 2011;
57(4):
399 - 408.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Tran, J. Tafreshi, and R. G. Pai
Review Article: Combination of Clopidogrel and Proton Pump Inhibitors: Implications for Clinicians
Journal of Cardiovascular Pharmacology and Therapeutics,
December 1, 2010;
15(4):
326 - 337.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
S. D. Wiviott and J. L. Mega
Another Step on the Road to Tailored Antiplatelet Therapy
J. Am. Coll. Cardiol.,
November 9, 2010;
56(20):
1637 - 1638.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. F. Storey, D. J. Angiolillo, S. B. Patil, B. Desai, R. Ecob, S. Husted, H. Emanuelsson, C. P. Cannon, R. C. Becker, and L. Wallentin
Inhibitory Effects of Ticagrelor Compared With Clopidogrel on Platelet Function in Patients With Acute Coronary Syndromes: The PLATO (PLATelet inhibition and patient Outcomes) PLATELET Substudy
J. Am. Coll. Cardiol.,
October 26, 2010;
56(18):
1456 - 1462.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S.-J. Hwang, Y.-H. Jeong, I.-S. Kim, K.-S. Park, M.-K. Kang, J.-S. Koh, J. R. Park, Y. Park, E.-H. Koh, C. H. Kwak, et al.
Cytochrome 2C19 Polymorphism and Response to Adjunctive Cilostazol Versus High Maintenance-Dose Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention
Circ Cardiovasc Interv,
October 1, 2010;
3(5):
450 - 459.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. L. Ferreiro, M. Ueno, D. Capodanno, B. Desai, K. Dharmashankar, A. Darlington, R. K. Charlton, T. A. Bass, and D. J. Angiolillo
Pharmacodynamic Effects of Concomitant Versus Staggered Clopidogrel and Omeprazole Intake: Results of a Prospective Randomized Crossover Study
Circ Cardiovasc Interv,
October 1, 2010;
3(5):
436 - 441.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. Bonello, U. S. Tantry, R. Marcucci, R. Blindt, D. J. Angiolillo, R. Becker, D. L. Bhatt, M. Cattaneo, J. P. Collet, T. Cuisset, et al.
Consensus and Future Directions on the Definition of High On-Treatment Platelet Reactivity to Adenosine Diphosphate
J. Am. Coll. Cardiol.,
September 14, 2010;
56(12):
919 - 933.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. H. Buch, B. D. Prendergast, and R. F. Storey
Antiplatelet therapy and vascular disease: an update
Therapeutic Advances in Cardiovascular Disease,
August 1, 2010;
4(4):
249 - 275.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
R. Wada, S. Rohatagi, D. Small, K. J. Winters, and D. E. Salazar
Correlation of Inhibition of Platelet Aggregation With Cardiovascular and Bleeding Outcomes in Acute Coronary Syndromes
J. Clin. Pharmacol.,
August 1, 2010;
50(8):
904 - 913.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. S. Roffman
Considerations in patients receiving oral antiplatelet therapy after acute coronary syndrome and percutaneous coronary intervention
Am. J. Health Syst. Pharm.,
August 1, 2010;
67(15_Supplement_7):
S18 - S24.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. D. Wiviott, E. M. Antman, and E. Braunwald
Prasugrel
Circulation,
July 27, 2010;
122(4):
394 - 403.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Y.-H. Jeong, I.-S. Kim, Y. Park, M.-K. Kang, J.-S. Koh, S.-J. Hwang, C. H. Kwak, and J.-Y. Hwang
Carriage of Cytochrome 2C19 Polymorphism Is Associated With Risk of High Post-Treatment Platelet Reactivity on High Maintenance-Dose Clopidogrel of 150 mg/day: Results of the ACCEL-DOUBLE (Accelerated Platelet Inhibition by a Double Dose of Clopidogrel According to Gene Polymorphism) Study
J. Am. Coll. Cardiol. Intv.,
July 1, 2010;
3(7):
731 - 741.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
W. Hochholzer, D. Trenk, M. F. Fromm, C. M. Valina, C. Stratz, H. P. Bestehorn, H. J. Buttner, and F. J. Neumann
Impact of Cytochrome P450 2C19 Loss-of-Function Polymorphism and of Major Demographic Characteristics on Residual Platelet Function After Loading and Maintenance Treatment With Clopidogrel in Patients Undergoing Elective Coronary Stent Placement
J. Am. Coll. Cardiol.,
June 1, 2010;
55(22):
2427 - 2434.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. J. Price, A. Kalyanasundaram, and P. B. Berger
The Evidence Base for Platelet Function Testing in Patients Undergoing Percutaneous Coronary Intervention
Circ Cardiovasc Interv,
June 1, 2010;
3(3):
277 - 283.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. E. Ghannudi, P. Ohlmann, N. Meyer, M.-L. Wiesel, B. Radulescu, M. Chauvin, P. Bareiss, C. Gachet, and O. Morel
Impact of P2Y 12 Inhibition by Clopidogrel on Cardiovascular Mortality in Unselected Patients Treated by Percutaneous Coronary Angioplasty: A Prospective Registry
J. Am. Coll. Cardiol. Intv.,
June 1, 2010;
3(6):
648 - 656.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Sibbing, N. von Beckerath, T. Morath, J. Stegherr, J. Mehilli, N. Sarafoff, S. Braun, S. Schulz, A. Schomig, and A. Kastrati
Oral anticoagulation with coumarin derivatives and antiplatelet effects of clopidogrel
Eur. Heart J.,
May 2, 2010;
31(10):
1205 - 1211.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. J. Angiolillo, E. Bernardo, D. Capodanno, D. Vivas, M. Sabate, J. L. Ferreiro, M. Ueno, P. Jimenez-Quevedo, F. Alfonso, T. A. Bass, et al.
Impact of Chronic Kidney Disease on Platelet Function Profiles in Diabetes Mellitus Patients With Coronary Artery Disease Taking Dual Antiplatelet Therapy
J. Am. Coll. Cardiol.,
March 16, 2010;
55(11):
1139 - 1146.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. J. Breet, J. W. van Werkum, H. J. Bouman, J. C. Kelder, H. J. T. Ruven, E. T. Bal, V. H. Deneer, A. M. Harmsze, J. A. S. van der Heyden, B. J. W. M. Rensing, et al.
Comparison of Platelet Function Tests in Predicting Clinical Outcome in Patients Undergoing Coronary Stent Implantation
JAMA,
February 24, 2010;
303(8):
754 - 762.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Sibbing, J. Stegherr, S. Braun, J. Mehilli, S. Schulz, M. Seyfarth, A. Kastrati, N. von Beckerath, and A. Schomig
A Double-Blind, Randomized Study on Prevention and Existence of a Rebound Phenomenon of Platelets After Cessation of Clopidogrel Treatment
J. Am. Coll. Cardiol.,
February 9, 2010;
55(6):
558 - 565.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Sibbing, W. Koch, D. Gebhard, T. Schuster, S. Braun, J. Stegherr, T. Morath, A. Schomig, N. von Beckerath, and A. Kastrati
Cytochrome 2C19*17 Allelic Variant, Platelet Aggregation, Bleeding Events, and Stent Thrombosis in Clopidogrel-Treated Patients With Coronary Stent Placement
Circulation,
February 2, 2010;
121(4):
512 - 518.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. Gremmel, S. Steiner, D. Seidinger, R. Koppensteiner, S. Panzer, and C. W. Kopp
Calcium-channel blockers decrease clopidogrel-mediated platelet inhibition
Heart,
February 1, 2010;
96(3):
186 - 189.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. A. Farid, A. Kurihara, and S. A. Wrighton
Metabolism and Disposition of the Thienopyridine Antiplatelet Drugs Ticlopidine, Clopidogrel, and Prasugrel in Humans
J. Clin. Pharmacol.,
February 1, 2010;
50(2):
126 - 142.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. Geisler, C. Zurn, R. Simonenko, M. Rapin, H. Kraibooj, A. Kilias, B. Bigalke, K. Stellos, M. Schwab, A. E. May, et al.
Early but not late stent thrombosis is influenced by residual platelet aggregation in patients undergoing coronary interventions
Eur. Heart J.,
January 1, 2010;
31(1):
59 - 66.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. Dangas, R. Mehran, G. Guagliumi, A. Caixeta, B. Witzenbichler, J. Aoki, J. Z. Peruga, B. R. Brodie, D. Dudek, R. Kornowski, et al.
Role of Clopidogrel Loading Dose in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty: Results From the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) Trial
J. Am. Coll. Cardiol.,
October 6, 2009;
54(15):
1438 - 1446.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Shimbo, W. Chaplin, S. Kuruvilla, L. T. Wasson, D. Abraham, and M. M. Burg
Hostility and Platelet Reactivity in Individuals Without a History of Cardiovascular Disease Events
Psychosom Med,
September 1, 2009;
71(7):
741 - 747.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. Wallentin
P2Y12 inhibitors: differences in properties and mechanisms of action and potential consequences for clinical use
Eur. Heart J.,
August 2, 2009;
30(16):
1964 - 1977.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. Verstuyft, T. Simon, and R. B. Kim
Personalized medicine and antiplatelet therapy: ready for prime time?
Eur. Heart J.,
August 2, 2009;
30(16):
1943 - 1963.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. S. Ernest II, M. A. Heathman, and R. E. Wrishko
Prediction of Prasugrel Active Metabolite Concentrations From 2 Downstream Inactive Metabolite Concentrations Using Multilinear Regression Analysis
J. Clin. Pharmacol.,
August 1, 2009;
49(8):
973 - 983.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. D. Michelson, A. L. Frelinger III, E. Braunwald, W. E. Downey, D. J. Angiolillo, N. P. Xenopoulos, J. A. Jakubowski, Y. Li, S. A. Murphy, J. Qin, et al.
Pharmacodynamic assessment of platelet inhibition by prasugrel vs. clopidogrel in the TRITON-TIMI 38 trial
Eur. Heart J.,
July 2, 2009;
30(14):
1753 - 1763.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. B Norgard, K. D Mathews, and G. C Wall
Drug-Drug Interaction Between Clopidogrel and the Proton Pump Inhibitors
Ann. Pharmacother.,
July 1, 2009;
43(7):
1266 - 1274.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Valgimigli, G. Campo, N. de Cesare, E. Meliga, P. Vranckx, A. Furgieri, D. J. Angiolillo, M. Sabate, M. Hamon, A. Repetto, et al.
Intensifying Platelet Inhibition With Tirofiban in Poor Responders to Aspirin, Clopidogrel, or Both Agents Undergoing Elective Coronary Intervention: Results From the Double-Blind, Prospective, Randomized Tailoring Treatment With Tirofiban in Patients Showing Resistance to Aspirin and/or Resistance to Clopidogrel Study
Circulation,
June 30, 2009;
119(25):
3215 - 3222.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. J. Price
Bedside Evaluation of Thienopyridine Antiplatelet Therapy
Circulation,
May 19, 2009;
119(19):
2625 - 2632.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. L. Mega, S. L. Close, S. D. Wiviott, L. Shen, R. D. Hockett, J. T. Brandt, J. R. Walker, E. M. Antman, W. L. Macias, E. Braunwald, et al.
Cytochrome P450 Genetic Polymorphisms and the Response to Prasugrel: Relationship to Pharmacokinetic, Pharmacodynamic, and Clinical Outcomes
Circulation,
May 19, 2009;
119(19):
2553 - 2560.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Tousoulis, A. Briasoulis, S. S Dhamrait, C. Antoniades, and C. Stefanadis
Effective platelet inhibition by aspirin and clopidogrel: where are we now?
Heart,
May 1, 2009;
95(10):
850 - 858.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. F. Ford
Clopidogrel Resistance: Pharmacokinetic or Pharmacogenetic?
J. Clin. Pharmacol.,
May 1, 2009;
49(5):
506 - 512.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. R. Desai, J. L. Mega, S. Jiang, C. P. Cannon, and M. S. Sabatine
Interaction Between Cigarette Smoking and Clinical Benefit of Clopidogrel
J. Am. Coll. Cardiol.,
April 14, 2009;
53(15):
1273 - 1278.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Sibbing, J. Stegherr, W. Latz, W. Koch, J. Mehilli, K. Dorrler, T. Morath, A. Schomig, A. Kastrati, and N. von Beckerath
Cytochrome P450 2C19 loss-of-function polymorphism and stent thrombosis following percutaneous coronary intervention
Eur. Heart J.,
April 2, 2009;
30(8):
916 - 922.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Y.-H. Jeong, S.-W. Lee, B.-R. Choi, I.-S. Kim, M.-K. Seo, C. H. Kwak, J.-Y. Hwang, and S.-W. Park
Randomized Comparison of Adjunctive Cilostazol Versus High Maintenance Dose Clopidogrel in Patients With High Post-Treatment Platelet Reactivity: Results of the ACCEL-RESISTANCE (Adjunctive Cilostazol Versus High Maintenance Dose Clopidogrel in Patients With Clopidogrel Resistance) Randomized Study
J. Am. Coll. Cardiol.,
March 31, 2009;
53(13):
1101 - 1109.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Sibbing, S. Braun, T. Morath, J. Mehilli, W. Vogt, A. Schomig, A. Kastrati, and N. von Beckerath
Platelet Reactivity After Clopidogrel Treatment Assessed With Point-of-Care Analysis and Early Drug-Eluting Stent Thrombosis
J. Am. Coll. Cardiol.,
March 10, 2009;
53(10):
849 - 856.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. Mahla, M. J. Antonino, U. S. Tantry, and P. A. Gurbel
Point-of-Care Platelet Function Analysis: Ready for Prime Time?
J. Am. Coll. Cardiol.,
March 10, 2009;
53(10):
857 - 859.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
W. Kuliczkowski, A. Witkowski, L. Polonski, C. Watala, K. Filipiak, A. Budaj, J. Golanski, D. Sitkiewicz, J. Pregowski, J. Gorski, et al.
Interindividual variability in the response to oral antiplatelet drugs: a position paper of the Working Group on antiplatelet drugs resistance appointed by the Section of Cardiovascular Interventions of the Polish Cardiac Society, endorsed by the Working Group on Thrombosis of the European Society of Cardiology
Eur. Heart J.,
February 2, 2009;
30(4):
426 - 435.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. M. Scott, R. M Norwood, and D. Parra
P2Y12 Inhibitors in Cardiovascular Disease: Focus on Prasugrel
Ann. Pharmacother.,
January 1, 2009;
43(1):
64 - 76.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Erlinge, C. Varenhorst, O. O. Braun, S. James, K. J. Winters, J. A. Jakubowski, J. T. Brandt, A. Sugidachi, A. Siegbahn, and L. Wallentin
Patients With Poor Responsiveness to Thienopyridine Treatment or With Diabetes Have Lower Levels of Circulating Active Metabolite, but Their Platelets Respond Normally to Active Metabolite Added Ex Vivo
J. Am. Coll. Cardiol.,
December 9, 2008;
52(24):
1968 - 1977.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. A. Cairns and J. Eikelboom
The Pursuit of Clinically Relevant Measures of Platelet Function After Antiplatelet Drug Therapy
J. Am. Coll. Cardiol.,
December 9, 2008;
52(24):
1978 - 1980.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. Cuisset, C. Frere, J. Quilici, P.-E. Morange, J.-P. Mouret, L. Bali, P.-J. Moro, M. Lambert, M.-C. Alessi, and J. L. Bonnet
Glycoprotein IIb/IIIa Inhibitors Improve Outcome After Coronary Stenting in Clopidogrel Nonresponders: A Prospective, Randomized Study
J. Am. Coll. Cardiol. Intv.,
December 1, 2008;
1(6):
649 - 653.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. Patti, A. Nusca, F. Mangiacapra, L. Gatto, A. D'Ambrosio, and G. Di Sciascio
Point-of-Care Measurement of Clopidogrel Responsiveness Predicts Clinical Outcome in Patients Undergoing Percutaneous Coronary Intervention: Results of the ARMYDA-PRO (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty-Platelet Reactivity Predicts Outcome) Study
J. Am. Coll. Cardiol.,
September 30, 2008;
52(14):
1128 - 1133.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. O. Williams and J. D. Abbott
What to Do With Patients Receiving Long-Term Clopidogrel: Reload or Relax?
Circulation,
September 16, 2008;
118(12):
1219 - 1222.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J.-P. Collet, J. Silvain, A. Landivier, M.-L. Tanguy, G. Cayla, A. Bellemain, N. Vignolles, S. Gallier, F. Beygui, A. Pena, et al.
Dose Effect of Clopidogrel Reloading in Patients Already on 75-mg Maintenance Dose: The Reload With Clopidogrel Before Coronary Angioplasty in Subjects Treated Long Term With Dual Antiplatelet Therapy (RELOAD) Study
Circulation,
September 16, 2008;
118(12):
1225 - 1233.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. M. Gori, R. Marcucci, A. Migliorini, R. Valenti, G. Moschi, R. Paniccia, P. Buonamici, G. F. Gensini, R. Vergara, R. Abbate, et al.
Incidence and Clinical Impact of Dual Nonresponsiveness to Aspirin and Clopidogrel in Patients With Drug-Eluting Stents
J. Am. Coll. Cardiol.,
August 26, 2008;
52(9):
734 - 739.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Trenk and F.-J. Neumann
Aspirin Resistance: An Underestimated Risk in Patients With Drug-Eluting Stents?
J. Am. Coll. Cardiol.,
August 26, 2008;
52(9):
740 - 742.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. T. Newsome, R. S. Weller, J. C. Gerancher, M. A. Kutcher, and R. L. Royster
Coronary Artery Stents: II. Perioperative Considerations and Management
Anesth. Analg.,
August 1, 2008;
107(2):
570 - 590.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. Geisler, C. Zurn, M. Paterok, K. Gohring-Frischholz, B. Bigalke, K. Stellos, P. Seizer, B. F. Kraemer, J. Dippon, A. E. May, et al.
Statins do not adversely affect post-interventional residual platelet aggregation and outcomes in patients undergoing coronary stenting treated by dual antiplatelet therapy
Eur. Heart J.,
July 1, 2008;
29(13):
1635 - 1643.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Widimsky, Z. Motovska, S. Simek, P. Kala, R. Pudil, F. Holm, R. Petr, D. Bilkova, H. Skalicka, P. Kuchynka, et al.
Clopidogrel pre-treatment in stable angina: for all patients >6 h before elective coronary angiography or only for angiographically selected patients a few minutes before PCI? A randomized multicentre trial PRAGUE-8
Eur. Heart J.,
June 2, 2008;
29(12):
1495 - 1503.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Sibbing, G. Busch, S. Braun, S. Jawansky, A. Schomig, A. Kastrati, I. Ott, and N. von Beckerath
Impact of bivalirudin or unfractionated heparin on platelet aggregation in patients pretreated with 600 mg clopidogrel undergoing elective percutaneous coronary intervention
Eur. Heart J.,
June 2, 2008;
29(12):
1504 - 1509.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T Geisler, M Kapp, K Gohring-Frischholz, K Daub, C Dosch, B Bigalke, H Langer, C Herdeg, and M Gawaz
Residual platelet activity is increased in clopidogrel- and ASA-treated patients with coronary stenting for acute coronary syndromes compared with stable coronary artery disease
Heart,
June 1, 2008;
94(6):
743 - 747.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Trenk, W. Hochholzer, M. F. Fromm, L.-E. Chialda, A. Pahl, C. M. Valina, C. Stratz, P. Schmiebusch, H.-P. Bestehorn, H. J. Buttner, et al.
Cytochrome P450 2C19 681G>A Polymorphism and High On-Clopidogrel Platelet Reactivity Associated With Adverse 1-Year Clinical Outcome of Elective Percutaneous Coronary Intervention With Drug-Eluting or Bare-Metal Stents
J. Am. Coll. Cardiol.,
May 20, 2008;
51(20):
1925 - 1934.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. A. Cairns and J. Eikelboom
Clopidogrel Resistance: More Grist for the Mill
J. Am. Coll. Cardiol.,
May 20, 2008;
51(20):
1935 - 1937.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J.-P. Bassand
Unmet needs in antiplatelet therapy
Eur. Heart J. Suppl.,
May 1, 2008;
10(suppl_D):
D3 - D11.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. Wallentin
Dual antiplatelet therapy in the drug-eluting stent era
Eur. Heart J. Suppl.,
May 1, 2008;
10(suppl_D):
D38 - D44.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. J. Price, S. Endemann, R. R. Gollapudi, R. Valencia, C. T. Stinis, J. P. Levisay, A. Ernst, N. S. Sawhney, R. A. Schatz, and P. S. Teirstein
Prognostic significance of post-clopidogrel platelet reactivity assessed by a point-of-care assay on thrombotic events after drug-eluting stent implantation
Eur. Heart J.,
April 2, 2008;
29(8):
992 - 1000.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Muller-Schunk, J. Linn, N. Peters, M. Spannagl, M. Deisenberg, H. Bruckmann, and T.E. Mayer
Monitoring of Clopidogrel-Related Platelet Inhibition: Correlation of Nonresponse with Clinical Outcome in Supra-Aortic Stenting
AJNR Am. J. Neuroradiol.,
April 1, 2008;
29(4):
786 - 791.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. J. Kereiakes and P. A. Gurbel
Peri-Procedural Platelet Function and Platelet Inhibition in Percutaneous Coronary Intervention
J. Am. Coll. Cardiol. Intv.,
April 1, 2008;
1(2):
111 - 121.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. L. L'Allier, G. Ducrocq, N. Pranno, S. Noble, R. Ibrahim, J. C. Gregoire, F. Azzari, A. Nozza, C. Berry, S. Doucet, et al.
Clopidogrel 600-Mg Double Loading Dose Achieves Stronger Platelet Inhibition Than Conventional Regimens: Results From the PREPAIR Randomized Study
J. Am. Coll. Cardiol.,
March 18, 2008;
51(11):
1066 - 1072.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. D. Michelson
P2Y12 Antagonism: Promises and Challenges
Arterioscler Thromb Vasc Biol,
March 1, 2008;
28(3):
s33 - s38.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. E. Kip, K. Hollabaugh, O. C. Marroquin, and D. O. Williams
The Problem With Composite End Points in Cardiovascular Studies: The Story of Major Adverse Cardiac Events and Percutaneous Coronary Intervention
J. Am. Coll. Cardiol.,
February 19, 2008;
51(7):
701 - 707.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. D. Wiviott, D. Trenk, A. L. Frelinger, M. O'Donoghue, F.-J. Neumann, A. D. Michelson, D. J. Angiolillo, H. Hod, G. Montalescot, D. L. Miller, et al.
Prasugrel Compared With High Loading- and Maintenance-Dose Clopidogrel in Patients With Planned Percutaneous Coronary Intervention: The Prasugrel in Comparison to Clopidogrel for Inhibition of Platelet Activation and Aggregation Thrombolysis in Myocardial Infarction 44 Trial
Circulation,
December 18, 2007;
116(25):
2923 - 2932.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. A. Gurbel, R. C. Becker, K. G. Mann, S. R. Steinhubl, and A. D. Michelson
Platelet Function Monitoring in Patients With Coronary Artery Disease
J. Am. Coll. Cardiol.,
November 6, 2007;
50(19):
1822 - 1834.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. J. Angiolillo, E. Bernardo, M. Sabate, P. Jimenez-Quevedo, M. A. Costa, J. Palazuelos, R. Hernandez-Antolin, R. Moreno, J. Escaned, F. Alfonso, et al.
Impact of Platelet Reactivity on Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease
J. Am. Coll. Cardiol.,
October 16, 2007;
50(16):
1541 - 1547.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. Campo, M. Valgimigli, D. Gemmati, G. Percoco, L. Catozzi, A. Frangione, F. Federici, F. Ferrari, M. Tebaldi, S. Luccarelli, et al.
Poor Responsiveness to Clopidogrel: Drug-Specific or Class-Effect Mechanism?: Evidence From a Clopidogrel-to-Ticlopidine Crossover Study
J. Am. Coll. Cardiol.,
September 18, 2007;
50(12):
1132 - 1137.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. J. Weerakkody, J. A. Jakubowski, J. T. Brandt, C. D. Payne, H. Naganuma, and K. J. Winters
Greater Inhibition of Platelet Aggregation and Reduced Response Variability With Prasugrel Versus Clopidogrel: An Integrated Analysis
Journal of Cardiovascular Pharmacology and Therapeutics,
September 1, 2007;
12(3):
205 - 212.
[Abstract]
[PDF]
|
 |
|
|