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Review
. 2009:5:965-72.
doi: 10.2147/vhrm.s6787. Epub 2009 Nov 16.

Aspirin and clopidogrel hyporesponsiveness and nonresponsiveness in patients with coronary artery stenting

Rakesh K Sharma  1 , Hanumanth K Reddy, Vibhuti N Singh, Rohit Sharma, Donald J Voelker, Girish Bhatt
Affiliations
Review

Aspirin and clopidogrel hyporesponsiveness and nonresponsiveness in patients with coronary artery stenting

Rakesh K Sharma et al. Vasc Health Risk Manag. 2009.

Abstract

Patients undergoing coronary artery stenting receive an antiplatelet regimen to reduce the risk of antithrombotic complications. Current guidelines recommend the use of acetyl salicylic acid (aspirin) and clopidogrel as evidenced by large clinical trials. There has been a concern about variable responses of patients to aspirin and clopidogrel which may predispose them to subacute stent thrombosis or late stent thrombosis. Up to 25% of patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) were found to have hyporesponsiveness or resistance to clopidogrel which may predispose them to recurrent events. Dual antiplatelet regimen is a standard therapy in these patients and there is always a concern about variable responses to aspirin and clopidogrel predisposing them to acute coronary syndrome (ACS). Prevalence of this hyporesponsiveness or resistance may be due to noncompliance, genetic mutations, co-morbid situations and concomitant use of other drugs. This issue is of considerable importance in the era of coronary drug eluting stents when a long-term dual antiplatelet regimen is needed. This paper is a review for clinicians taking care of such patients with hyporesponsiveness or nonresponsiveness to dual antiplatelet regimen.

Keywords: acute coronary syndrome; aspirin; clopidogrel; coronary artery stenting.

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Figures

Figure 1
Figure 1
Understanding platelet function testing. Abbreviations: AA, arachidonic acid; PRU, P2Y12 reaction units; ARU, aspirin reaction units; TXA2, thromboxane A2.
See this image and copyright information in PMC

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