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Low responsiveness to clopidogrel increases risk among CKD patients undergoing coronary intervention.

Authors :
Htun P
Fateh-Moghadam S
Bischofs C
Banya W
Müller K
Bigalke B
Stellos K
May AE
Flather M
Gawaz M
Geisler T
Source :
Journal of the American Society of Nephrology : JASN [J Am Soc Nephrol] 2011 Apr; Vol. 22 (4), pp. 627-33. Date of Electronic Publication: 2011 Jan 27.
Publication Year :
2011

Abstract

Patients with CKD are at higher risk for major events after percutaneous coronary intervention (PCI) compared with subjects with normal renal function. The aims of this study were to evaluate responsiveness to clopidogrel in patients with CKD and to examine the effect of antiplatelet drug response on post-PCI outcome. We retrospectively evaluated a consecutive cohort of 1567 patients with symptomatic coronary artery disease undergoing PCI, 648 (41%) of whom had stage 3 to 5 CKD. We assessed responsiveness to clopidogrel by ADP-induced platelet aggregation after oral administration of a 600-mg clopidogrel loading dose and 100 mg of aspirin. In a multivariate survival analysis that included 1335 (85%) of the cohort, stage 3 to 5 CKD and low response to clopidogrel were independent predictors of the primary end point (composite of myocardial infarction, ischemic stroke, and death within 1 year). In summary, a low response to clopidogrel might be an additional risk factor for the poorer outcomes in patients with stage 3 to 5 CKD compared with patients with better renal function.<br /> (Copyright © 2011 by the American Society of Nephrology)

Details

Language :
English
ISSN :
1533-3450
Volume :
22
Issue :
4
Database :
MEDLINE
Journal :
Journal of the American Society of Nephrology : JASN
Publication Type :
Academic Journal
Accession number :
21273381
Full Text :
https://doi.org/10.1681/ASN.2010020220