Clinical importance of aspirin and clopidogrel resistance  

作　　者：Gergely Feher Andrea Feher Gabriella Pusch Katalin Koltai Antal Tibold Beata Gasztonyi Elod Papp Laszlo Szapary Gabor Kesmarky Kalman Toth 

机构地区：[1]Department of Neurology, University of Pecs [2]1st Department of Medicine, University of Pecs, School of Medicine [3]Department of Preventive Medicine, University of Pecs, School of Medicine [4]Division of Internal Medicine, Zala County Hospital

出　　处：《World Journal of Cardiology》2010年第7期171-186,共16页世界心脏病学杂志（英文版）（电子版）

基　　金：Supported by The University of Pecs (PTE AOK KA-34039-16/2009)

摘　　要：Aspirin and clopidogrel are important components of medical therapy for patients with acute coronary syndromes, for those who received coronary artery stents and in the secondary prevention of ischaemic stroke. Despite their use, a significant number of patients experience recurrent adverse ischaemic events. Interindividual variability of platelet aggregation in response to these antiplatelet agents may be an explanation for some of these recurrent events, and small trials have linked "aspirin and/or clopidogrel resistance", as measured by platelet function tests, to adverse events. We systematically reviewed all available evidence on the prevalence of aspirin/clopidogrel resistance, their possible risk factors and their association with clinical outcomes. We also identified articles showing possible treatments. After analyzing the data on different laboratory methods, we found that aspirin/clopidogrel resistance seems to be associated with poor clinical outcomes and there is currently no standardized or widely accepted definition of clopidogrel resistance. Therefore, we conclude that specific treatment recommendations are not established for patients who exhibit high platelet reactivity during aspirin/clopidogrel therapy or who have poor platelet inhibition by clopidogrel.Aspirin and clopidogrel are important components of medical therapy for patients with acute coronary syndromes, for those who received coronary artery stents and in the secondary prevention of ischaemic stroke. Despite their use, a significant number of patients experience recurrent adverse ischaemic events. Interindividual variability of platelet aggregation in response to these antiplatelet agents may be an explanation for some of these recurrent events, and small trials have linked “aspirin and/or clopidogrel resistance”, as measured by platelet function tests, to adverse events. We systematically reviewed all available evidence on the prevalence of aspirin/clopidogrel resistance, their possible risk factors and their association with clinical outcomes. We also identified articles showing possible treatments. After analyzing the data on different laboratory methods, we found that aspirin/clopidogrel resistance seems to be associated with poor clinical outcomes and there is currently no standardized or widely accepted definition of clopidogrel resistance. Therefore, we conclude that specific treatment recommendations are not established for patients who exhibit high platelet reactivity during aspirin/clopidogrel therapy or who have poor platelet inhibition by clopidogrel.

关 键 词：ASPIRIN CLOPIDOGREL ANTIPLATELET agent ASPIRIN RESISTANCE CLOPIDOGREL RESISTANCE CARDIOVASCULAR outcome PLATELET aggregation 

分 类 号：R541.4[医药卫生—心血管疾病]