Glycoprotein IIb/IIIa Inhibitors Improve Outcome After Coronary Stenting in Clopidogrel Nonresponders A Prospective, Randomized Study. JACC. Cardiovascular interventions [JACC Cardiovasc Interv] Journal article | | Title | Glycoprotein IIb/IIIa Inhibitors Improve Outcome After Coronary Stenting in Clopidogrel Nonresponders A Prospective, Randomized Study. | | Author(s) | Cuisset T, Frere C, Quilici J, Morange PE, Mouret JP, Bali L, Moro PJ, Lambert M, Alessi MC, Bonnet JL | | Institution | Department of Cardiology, CHU Timone, Marseille, France; Inserm, U626, Faculté de Médecine, Laboratoire d'Hématologie, CHU Timone, Marseille, France. | | Source | JACC Cardiovasc Interv 2008 Dec; 1(6):649-653. | | Abstract | OBJECTIVES: The aim of this study was to assess, in clopidogrel nonresponders undergoing elective percutaneous coronary intervention (PCI), the benefit of adjusted antiplatelet therapy with glycoprotein (GP) IIb/IIIa antagonist administration during PCI for 1-month clinical outcome.
BACKGROUND: Numerous biological studies have reported interindividual variability in platelet response to clopidogrel with clinical relevance, and high post-treatment platelet reactivity (adenosine diphosphate-induced aggregation >70%) has been proposed to define nonresponse to clopidogrel. These nonresponders might benefit from tailored antiplatelet therapy.
METHODS: One hundred forty-nine clopidogrel nonresponders referred for elective PCI were prospectively included and randomized to "conventional group" (n = 75) or "active group" with GP IIb/IIIa antagonist (n = 74). All patients received 250-mg aspirin and 600-mg clopidogrel before PCI and platelet testing.
RESULTS: The rate of cardiovascular events at 1 month was significantly lower in the "active group" than in the "conventional group": 19% (n = 14) versus 40% (n = 30), p = 0.006, odds ratio: 2.8; 95% confidence interval: 1.4 to 6.0. No patient in either group had post-procedural Thrombolysis In Myocardial Infarction major bleeding or required transfusions.
CONCLUSIONS: The present study suggested benefit of tailored antiplatelet therapy during elective PCI with GP IIb/IIIa antagonist for clopidogrel nonresponders without increased bleeding risk. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19463379 |
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