Clopidogrel resistance: the way forward

Indian Heart J. 2014 Sep-Oct;66(5):530-4. doi: 10.1016/j.ihj.2014.08.012. Epub 2014 Oct 7.

Abstract

Clopidogrel, a second generation thienopyridine has been the mainstay of ACS (Acute Coronary Syndrome) treatment for more than a decade. Clopidogrel Resistance has been associated with increased mortality in ACS patients with an increase in number of Stent Thrombosis. This review article tries to find out the causes of Clopidogrel Resistance, the main factors involving it, Laboratory evaluation of Clopidogrel Resistance. The overall incidence of Clopidogrel Resistance across the Globe & India has also been considered. The article also discusses the clinical significance of Clopidogrel Resistance & its relationship with adverse cardiovascular events. This review ends with the probable solutions to Clopidogrel Resistance & the new generation of antiplatelets which can be used for the same.

Keywords: Clopidogrel resistance; Platelet reactivity; Prasugrel; Stent thrombosis; Ticagrelor.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / drug therapy*
  • Clopidogrel
  • Drug Resistance*
  • Humans
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine