Pharmacodynamic effect of clopidogrel in patients undergoing transcatheter aortic valve implantation
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
23956980
PubMed Central
PMC3728551
DOI
10.1155/2013/386074
Knihovny.cz E-zdroje
- MeSH
- aktivace trombocytů * MeSH
- akutní koronární syndrom patologie chirurgie MeSH
- aortální chlopeň patologie chirurgie MeSH
- cévní protézy * MeSH
- infarkt myokardu patologie chirurgie MeSH
- klopidogrel MeSH
- lidé MeSH
- následné studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- tiklopidin analogy a deriváty terapeutické užití MeSH
- trombocyty metabolismus MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- klopidogrel MeSH
- tiklopidin MeSH
The aim of this study was to analyze periprocedural and mid-term effect of clopidogrel on platelet function using the VerifyNow P2Y12 point-of-care assay in patients undergoing TAVI. Platelet reactivity was measured at the beginning of the procedure after 300 mg clopidogrel bolus administration and during the follow-up (at 1 month after the procedure) in 52 patients undergoing TAVI using the Medtronic CoreValve prosthesis (Medtronic CoreValve). A cutoff value of 240 PRU was used to identify nonresponders to clopidogrel treatment with high residual platelet reactivity (HRPR). Baseline HRPR was identified in 80% of patients and in 72% of patients during 6-month follow-up. There was no significant difference in the pharmacodynamic effects of clopidogrel on platelet reactivity from baseline to 6-months follow-up (297 ± 57 vs. 275 ± 62; P = 0.058). Ischemic event occurred only in 3 patients (5.8%) from the study group. In conclusion, majority of patients undergoing TAVI had high residual platelet reactivity after pretreatment with 300 mg of clopidogrel and during the 6-month follow-up at dual antiplatelet treatment. The noneffectiveness of clopidogrel in the TAVI population raises the question of the routine use of dual antiplatelet treatment in this setting.
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