Response to Clopidogrel and Its Association with Chronic Kidney Disease in Noncardiogenic Ischemic Stroke Patients
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- Maruyama Hajime
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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- Fukuoka Takuya
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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- Deguchi Ichiro
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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- Ohe Yasuko
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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- Kato Yuji
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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- Horiuchi Yohsuke
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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- Hayashi Takeshi
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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- Nagamine Yuito
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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- Sano Hiroyasu
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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- Tanahashi Norio
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
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抄録
Objective Noncardiogenic ischemic stroke patients with chronic kidney disease (CKD) are known to have a greater rate of ischemic stroke recurrence than those without. Although clopidogrel is often used to prevent the recurrence of noncardiogenic ischemic stroke, the relationship between the response to clopidogrel and CKD is unclear. In the present study, the relationship between the response to clopidogrel and the presence of CKD was investigated in noncardiogenic ischemic stroke patients.<br> Methods A total of 129 noncardiogenic ischemic stroke patients receiving 75 mg/day of clopidogrel for ≥1 week were evaluated. The VerifyNow P2Y12 Assay was used to measure the level of platelet aggregation induced by 20 μM of adenosine diphosphate, and the degree of platelet aggregation and frequency of clopidogrel resistance were compared between 34 patients with CKD and 95 patients without CKD. Clopidogrel resistance was defined as a P2Y12 Reaction Units (PRU) value of >230 and/or % inhibition <20%.<br> Results The PRU value was 201.9±91.3 in the patients with CKD and 163.3±86.4 in the patients without CKD (p=0.035). The frequency of a PRU value of >230 was 44.1% (15 patients) among the patients with CKD and 17.9% (17 patients) among those without CKD (p=0.002). The percent inhibition was 29.9%±28.1% among the patients with CKD and 41.1%±28.0% among the patients without CKD (p=0.030). The frequency of % inhibition <20% was 47.1% (16 patients) among the patients with CKD and 26.3% (25 patients) among those without CKD (p=0.026).<br> Conclusion The present study showed that noncardiogenic ischemic stroke patients with CKD have a greater frequency of clopidogrel resistance, thus suggesting that the response to clopidogrel is diminished in these patients.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 53 (3), 215-219, 2014
一般社団法人 日本内科学会
