LOW RESPONSIVENESS TO CLOPIDOGREL AND STENT THROMBOSIS

Abstract number: O-T-033

Buonamici¹ P., Marcucci² R., Migliorini¹ A., Paniccia² R., Santini¹ A., Gori² A., Moschi¹ G., Gensini² G., Abbate² R., Antoniucci¹ D.

¹¹Cardiology, AOU Careggi ²²Surgical and Medical Critical Area, University of Florence, Florence, Italy

How-to-cite Buonamici P, Marcucci R, Migliorini A, Paniccia R, Santini A, Gori A, Moschi G, Gensini G, Abbate R, Antoniucci D. LOW RESPONSIVENESS TO CLOPIDOGREL AND STENT THROMBOSIS. J Thromb Haemost 2007; 5 Supplement 2: O-T-033

Abstract

Introduction: There are no data about the impact of non-responsiveness to clopidogrel on the risk of drug-elutin stent thrombosis

Aim of our study was to determine whether non-responsiveness to clopidogrel as revealed by high in vitro residual platelet reactivity is predictive of drug-eluting stent thrombosis

Methods: We conducted a prospective observational cohort study from July 2005 to August 2006 in an academic hospital. We enrolled a total of 804 patients who had succeessful sirolimus or paclitaxel-eluting stent implantation and who were compliant to clopidogrel treatment for at least 6 months.All patients had the assessment of platelet function by optical aggregometry on platelet rich plasma induced by 10 micromol/L ADP after a loading dose of 600 mg of clopidogrel. Patients received chronic dual antiplatelet treatment (aspirin 325 mg and clopidogrel 75 mg daily)for 6 months.

Results: The incidence of 6-month definite/probable stent thrombosis was 3.1%. All stent thromboses wee subacute or late. Out of 804 aptients, 105 (13%)had a residual platelet reactivity (RPR)defined by a platelet aggregation >70%. The incidence of stent thrombosis was 8.6% in patients with RPR and 2.3% in the others (p<0.001). By multivariate analysis the predictors of stent thrombosis were: non-responsiveness to clopidogrel (HR=3.08, 95%CI 1.32-7.16; p=0.009), left ventricular ejection fraction (HR 0.95, 95%CI 0.92-0.98; p=0.001), total stent lenght (HR 1.01, 95%CI 1.00-1.02;p=0.01) and ST-segment elevation acute myocardial infarction (HR 2.41, 95%CI 1.04-5.63;p=0.041).

Conclusions: Non responsiveness to clopidogrel is a strong independent predictor of stent thrombosis in patients receiving drug-eluting stent.

To cite this abstract use the following format:

Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number

Session Details

Date:	01/08/2007
Time:	00:00-00:00
Session name:	XXIst ISTH Congress
Subject:
Location:	Oxford, UK
Presentation type:
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