Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Ischemic Heart Disease
Clopidogrel Resistance in Japanese Patients Scheduled forPercutaneous Coronary Intervention
Kozo Hoshino, Hisanori Horiuchi, Tomohisa Tada, Junichi Tazaki, Eiichiro Nishi, Mitsunori Kawato, Tomoyuki Ikeda, Hiromi Yamamoto, Masaharu Akao, Yutaka Furukawa, Satoshi Shizuta, Masanao Toma, Toshihiro Tamura, Naritatsu Saito, Takahiro Doi, Neiko Ozasa, Toshikazu Jinnai, Kanako Takahashi, Haruyo Watanabe, Yuka Yoshikawa, Naoko Nishimoto, Chiho Ouchi, Takeshi Morimoto, Toru Kita, Takeshi Kimura
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Keywords: Adenosine diphosphate, Antiplatelet drug, Clopidogrel, Coronary stent, Thienopiridine
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2009 Volume 73 Issue 2 Pages 336-342

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Abstract

Background Dual antiplatelet therapy with acetylsalicylic acid (ASA) and a P2Y12 ADP-receptor blocker is standard for prevention of coronary stent thrombosis. Clopidogrel, a 2nd-generation P2Y12 blocker, has recently become available in Japan and this study aimed to evaluate its antiplatelet effects in Japanese patients. Methods and Results Thirty Japanese patients scheduled for elective coronary stent implantation were enrolled. Under low-dose ASA therapy, 300 mg clopidogrel was loaded on the 1st day and a daily 75-mg dose was administered on the following days. Assessed by optical aggregometer, rapid inhibition occurred at 4 h, when the inhibition of platelet aggregation rate (IPA) was 16.4±12.8% using 5 μmol/L ADP as the stimulus. The antiplatelet efficacy of clopidogrel was reasonably constant in each patient throughout the study period, although there was a broad inter-individual variation. At 48 h after clopidogrel loading, the ratios of responders (IPA ≥30%), hypo-responders (10%≤IPA<30%), and non-responders (IPA <10%) were 36%, 50%, and 14%, respectively. Conclusions The antiplatelet effectiveness of clopidogrel appeared individual-specific with wide inter-individual variation. The rate of clopidogrel non-responders was 14% among the examined Japanese patients. (Circ J 2009; 73: 336 - 342)

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© 2009 THE JAPANESE CIRCULATION SOCIETY
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