Detection of Clopidogrel Hyporesponsiveness Using a Point-of-Care Assay and the Impact of Additional Cilostazol Administration after Coronary Stent Implantation in Diabetic Patients
The Korean Journal of Internal Medicine
; : 145-152, 2011.
Article
in En
| WPRIM
| ID: wpr-64780
Responsible library:
WPRO
ABSTRACT
BACKGROUND/AIMS: Impaired responsiveness to clopidogrel is common in patients with type 2 diabetes mellitus (DM). The aim of this study was to evaluate the clinical application of a point-of-care assay to detect impaired responsiveness to clopidogrel after coronary stent implantation in patients with type 2 DM. METHODS: We measured P2Y12 reaction units (PRU) with the VerifyNow point-of-care assay in 544 consecutive patients undergoing dual or triple (i.e., dual plus cilostazol) anti-platelet therapy after coronary stent implantation. High platelet reactivity (HPR) was defined as a PRU value > or = 240. RESULTS: The mean PRU values were 233.5 +/- 83.2 and 190.3 +/- 85.5 in patients undergoing dual or triple anti-platelet therapy, respectively (p < 0.001). Patients with DM manifested higher post treatment PRU values (238.3 +/- 82.4 vs. 210.8 +/- 86.8, p = 0.001) and a higher frequency of HPR (44.8% vs. 31.0%, p = 0.003) as compared to patients without DM. We also found that higher PRU values and a higher frequency of HPR were present in patients with DM who were undergoing both triple and dual anti-platelet therapy. However, the higher post-treatment PRU values observed in patients with DM decreased with triple anti-platelet therapy (219.4 +/- 82.5 vs. 247.9 +/- 81.1, p = 0.044). CONCLUSIONS: A point-of-care assay can detect elevated platelet reactivity and impaired responsiveness to clopidogrel in patients with type 2 DM. The addition of cilostazol to dual anti-platelet therapy may decrease post-treatment PRU values in patients with type 2 DM.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Platelet Function Tests
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Tetrazoles
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Ticlopidine
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Platelet Aggregation Inhibitors
/
Angioplasty, Balloon, Coronary
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Chi-Square Distribution
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Logistic Models
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Platelet Activation
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Stents
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Registries
Type of study:
Diagnostic_studies
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Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Limits:
Aged
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Female
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Humans
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
The Korean Journal of Internal Medicine
Year:
2011
Type:
Article