Objective. To determine whether nonresponsiveness to clopidogrel as revealed by high in vitro residual platelet reactivity after a 600 mg loading of the drug is predictive of drug-eluting stent thrombosis and cardiac mortality at long-term follow-up. Background.
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
To determine whether nonresponsiveness to clopidogrel as revealed by high in vitro residual platelet reactivity after a 600 mg loading of the drug is predictive of drug-eluting stent thrombosis and cardiac mortality at long-term follow-up
The RECLOSE trial showed that nonresponsiveness to clopidogrel is predictive of drug-eluting stent (DES) thrombosis and cardiac mortality at 6 months. No data exist about the predictive value of long-term adverse events in patients with DES and clopidogrel loading non-responsiveness
Platelet-rich plasma was stimulated with 10 M ADP and aggregation was assessed using LTA. Patients with platelet aggregation by 10 µmol ADP ≥ 90th percentile of controls (70%) were defined as nonresponders.
AND at least ONE additional criteria:
Secondary end-point: compositeofcardiacmortalityandstentthrombosis
LONG-TERM SURVIVAL FOR PRIMARY END-POINT Responsiveness to Clopidogrel
97 ± 1
Log rank p <.001
89 ± 3
Event-free survival %
(definite or probable stent thrombosis)
n=803 pts; median time follow-up 639 days - IQ 555-756
(after six months)
(after six months)
Conclusions Responsiveness to Clopidogrel
High residual platelet reactivity after 600 mg loading dose of clopidogrel, as revealed by a single assessment with LTA, is a strong predictor of cardiac death and DES thrombosis.