OBJECTIVE: To evaluate the prevalence and risk factors of clopidogrel resistance, and association between thromboembolic complications and clopidogrel resistance in patient with stent-assisted angioplasty for atherosclerotic cerebrovascular disease. METHODS: Between September 2006 and June 2008, clopidogrel resistance test was performed on 41 patients who underwent stent-assisted angioplasty for atherosclerotic cerebrovascular disease. It was performed before drug administration and about 12 hours after drug administration (loading dose : 300 mg, maintain dose : 75 mg). Two patients were excluded, and 41 patients were included (mean : 67.59±7.10 years, age range : 41-79). Among 41 patients, 18 patients had intracranial lesions, and 23 had extracranial lesions. We evaluated the prevalence, risk factors and complications related to clopidogrel resistance. RESULTS: Twenty-one patients (51.2%) showed clopidogrel resistance [intracranial : 10 patients (55.6%), extracranial : 11 patients (47.8%)] and no clopidogrel resistance was seen in 20 patients. Hypercholesterolemia was an indepedent risk factor of clopidogrel resistance. Stent-assisted angioplasty was technically successful in all patients, but acute in-stent thrombosis occurred in 5 patients with intracranial lesions (4 patients with clopidogrel resistance and 1 without clopidogrel resistance). Acute thrombi were completely lysed after intra-arterial infusion of abciximab. CONCLUSION: There was relatively high prevalence of clopidogrel resistance in patients with atherosclerotic cerebrovascular disease. Hypercholesterolemia was an independent predictive factor of clopidogrel resistance. Acute in-stent thrombosis was more frequently seen in the clopidogrel resistant group. Therefore, clopidogrel resistance test should be performed to avoid thromboembolic complications related to stent-assisted angioplasty for atherosclerotic cerebrovascular disease, especially patients with hypercholeterolemia and intracranial lesion.
OBJECTIVE: To evaluate the prevalence and risk factors of clopidogrel resistance, and association between thromboembolic complications and clopidogrel resistance in patient with stent-assisted angioplasty for atherosclerotic cerebrovascular disease. METHODS: Between September 2006 and June 2008, clopidogrel resistance test was performed on 41 patients who underwent stent-assisted angioplasty for atherosclerotic cerebrovascular disease. It was performed before drug administration and about 12 hours after drug administration (loading dose : 300 mg, maintain dose : 75 mg). Two patients were excluded, and 41 patients were included (mean : 67.59±7.10 years, age range : 41-79). Among 41 patients, 18 patients had intracranial lesions, and 23 had extracranial lesions. We evaluated the prevalence, risk factors and complications related to clopidogrel resistance. RESULTS: Twenty-one patients (51.2%) showed clopidogrel resistance [intracranial : 10 patients (55.6%), extracranial : 11 patients (47.8%)] and no clopidogrel resistance was seen in 20 patients. Hypercholesterolemia was an indepedent risk factor of clopidogrel resistance. Stent-assisted angioplasty was technically successful in all patients, but acute in-stent thrombosis occurred in 5 patients with intracranial lesions (4 patients with clopidogrel resistance and 1 without clopidogrel resistance). Acute thrombi were completely lysed after intra-arterial infusion of abciximab. CONCLUSION: There was relatively high prevalence of clopidogrel resistance in patients with atherosclerotic cerebrovascular disease. Hypercholesterolemia was an independent predictive factor of clopidogrel resistance. Acute in-stent thrombosis was more frequently seen in the clopidogrel resistant group. Therefore, clopidogrel resistance test should be performed to avoid thromboembolic complications related to stent-assisted angioplasty for atherosclerotic cerebrovascular disease, especially patients with hypercholeterolemia and intracranial lesion.
Authors: Tomas Jernberg; Christopher D Payne; Kenneth J Winters; Christelle Darstein; John T Brandt; Joseph A Jakubowski; Hideo Naganuma; Agneta Siegbahn; Lars Wallentin Journal: Eur Heart J Date: 2006-04-18 Impact factor: 29.983
Authors: Dominick J Angiolillo; Piera Capranzano; Shinya Goto; Mohammed Aslam; Bhaloo Desai; Ronald K Charlton; Yoshie Suzuki; Lyndon C Box; Steven B Shoemaker; Martin M Zenni; Luis A Guzman; Theodore A Bass Journal: Eur Heart J Date: 2008-06-21 Impact factor: 29.983
Authors: David A Morrow; Stephen D Wiviott; Harvey D White; Jose C Nicolau; Ezio Bramucci; Sabina A Murphy; Marc P Bonaca; Christian T Ruff; Benjamin M Scirica; Carolyn H McCabe; Elliott M Antman; Eugene Braunwald Journal: Circulation Date: 2009-05-18 Impact factor: 29.690
Authors: Wei C Lau; Lucy A Waskell; Paul B Watkins; Charlene J Neer; Kevin Horowitz; Amy S Hopp; Alan R Tait; David G M Carville; Kirk E Guyer; Eric R Bates Journal: Circulation Date: 2003-01-07 Impact factor: 29.690
Authors: Shlomi Matetzky; Boris Shenkman; Victor Guetta; Michael Shechter; Roy Beinart; Roy Bienart; Ilan Goldenberg; Ilya Novikov; Hanna Pres; Naphtali Savion; David Varon; Hanoch Hod Journal: Circulation Date: 2004-06-07 Impact factor: 29.690
Authors: Deepak L Bhatt; A Michael Lincoff; C Michael Gibson; Gregg W Stone; Steven McNulty; Gilles Montalescot; Neal S Kleiman; Shaun G Goodman; Harvey D White; Kenneth W Mahaffey; Charles V Pollack; Steven V Manoukian; Petr Widimsky; Derek P Chew; Fernando Cura; Ivan Manukov; Frantisek Tousek; M Zubair Jafar; Jaspal Arneja; Simona Skerjanec; Robert A Harrington Journal: N Engl J Med Date: 2009-12-10 Impact factor: 91.245
Authors: M Lin; M Todaro; J Chan; L Churilov; W S Zhu; S Ramdave; P J Mitchell; R J Dowling; P Kwan; B Yan Journal: AJNR Am J Neuroradiol Date: 2015-09-03 Impact factor: 3.825