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Factors associated with clopidogrel resistance and clinical outcomes in ischemic cerebrovascular disease: A retrospective study.
Wu, Yanzi; Shen, Huachao; Cai, Biyang; Chen, Chen; Yin, Qiong; Zhao, Yulei; Zhou, Guohua.
Afiliación
  • Wu Y; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China.
  • Shen H; Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
  • Cai B; Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
  • Chen C; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China.
  • Yin Q; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China.
  • Zhao Y; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China.
  • Zhou G; Department of Clinical Pharmacy, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No 305 Zhongshan East Road, Xuanwu District, Nanjing 210002, China. Electronic address: ghzhou@nju.edu.cn.
J Stroke Cerebrovasc Dis ; 33(6): 107684, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38518890
ABSTRACT

OBJECTIVE:

Clopidogrel resistance may lead to the recurrence of cerebrovascular diseases. We aimed to identify potential factors associated with clopidogrel resistance and evaluate the clinical outcomes of the patients. MATERIALS AND

METHODS:

In this retrospective study, patients with ischemic cerebrovascular disease treated with clopidogrel were included and classified into 2 groups according to the adenosine diphosphate (ADP)-induced platelet aggregation. Patients with the ADP inhibition rate of <30 % were included in clopidogrel resistance group, otherwise were included in clopidogrel sensitive group. CYP2C19 genotype and other clinical data were analyzed to identify factors and clinical features in the multivariate analysis. The outcomes were vascular events in 6 months.

RESULTS:

In total, 139 patients were enrolled with 81 (58.27 %) in clopidogrel sensitive group and 58 (41.73 %) in clopidogrel resistance group. Female and CYP2C19 *2*3 carrying were risk factors for clopidogrel resistance, and female was an independent risk factor (OR 2.481, 95 % CI 1.066-5.771, P=0.035). The clopidogrel resistance group showed a higher use rate of argatroban (P=0.030) and a lower arachidonic acid-induced inhibition of platelet aggregation (P=0.036). Clopidogrel resistance was related to the progressing stroke (HR 3.521, 95 % CI 1.352-9.170, P=0.010), but had no influence on the bleeding events (P>0.05).

CONCLUSIONS:

The risk of clopidogrel resistance increased significantly in female patients. Patients with clopidogrel resistance may have an increased incidence of stroke progression in the acute phase.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Resistencia a Medicamentos / Inhibidores de Agregación Plaquetaria / Agregación Plaquetaria / Citocromo P-450 CYP2C19 / Clopidogrel Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article País de afiliación: China

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Resistencia a Medicamentos / Inhibidores de Agregación Plaquetaria / Agregación Plaquetaria / Citocromo P-450 CYP2C19 / Clopidogrel Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article País de afiliación: China