Clopidogrel Resistance in Japanese Patients Scheduled forPercutaneous Coronary Intervention

• Hoshino Kozo

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Horiuchi Hisanori

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Tada Tomohisa

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Tazaki Junichi

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Nishi Eiichiro

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Kawato Mitsunori

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Ikeda Tomoyuki

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Yamamoto Hiromi

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Akao Masaharu

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Furukawa Yutaka

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Shizuta Satoshi

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Toma Masanao

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Tamura Toshihiro

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Saito Naritatsu

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Doi Takahiro

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Ozasa Neiko

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Jinnai Toshikazu

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Takahashi Kanako

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Watanabe Haruyo

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Yoshikawa Yuka

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Nishimoto Naoko

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Ouchi Chiho

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Morimoto Takeshi

  Center for Medical Education, Graduate School of Medicine, Kyoto University

• Kita Toru

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Kimura Takeshi

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

Abstract

Background Dual antiplatelet therapy with acetylsalicylic acid (ASA) and a P2Y₁₂ ADP-receptor blocker is standard for prevention of coronary stent thrombosis. Clopidogrel, a 2^nd-generation P2Y₁₂ blocker, has recently become available in Japan and this study aimed to evaluate its antiplatelet effects in Japanese patients. Methods and Results Thirty Japanese patients scheduled for elective coronary stent implantation were enrolled. Under low-dose ASA therapy, 300 mg clopidogrel was loaded on the 1^st day and a daily 75-mg dose was administered on the following days. Assessed by optical aggregometer, rapid inhibition occurred at 4 h, when the inhibition of platelet aggregation rate (IPA) was 16.4±12.8% using 5 μmol/L ADP as the stimulus. The antiplatelet efficacy of clopidogrel was reasonably constant in each patient throughout the study period, although there was a broad inter-individual variation. At 48 h after clopidogrel loading, the ratios of responders (IPA ≥30%), hypo-responders (10%≤IPA<30%), and non-responders (IPA <10%) were 36%, 50%, and 14%, respectively. Conclusions The antiplatelet effectiveness of clopidogrel appeared individual-specific with wide inter-individual variation. The rate of clopidogrel non-responders was 14% among the examined Japanese patients. (Circ J 2009; 73: 336 - 342)<br>

Journal

• Circulation Journal

  Circulation Journal 73 (2), 336-342, 2009

  The Japanese Circulation Society

Keywords

• Adenosine diphosphate
• Antiplatelet drug
• Clopidogrel
• Coronary stent
• Thienopiridine

Details

• CRID: 1390001205105152000
• NII Article ID: 110007042175
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-08-0559
• ISSN: 13474820
• ISSN: 13469843
• Web Site: http://www.jstage.jst.go.jp/article/circj/73/2/73_CJ-08-0559/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2009159769
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed