[Clopidogrel resistance].
Platelets play a critical role in pathogenesis of atherothrombotic diseases such as acute coronary syndromes and ischemic stroke. Clopidogrel, a thienopyridine derivative is an effective antiplatelet drug mostly used in combination with aspirin or as a single drug in aspirin intolerant patients. However, despite its proven efficacy in various clinical trials, some patients exhibit impaired response to clopidogrel and have activated platelets while on usual clopidogrel treatment. Although definition and mechanism(s) of this therapeutic failure are poorly understood, it is associated with higher morbidity and mortality as in aspirin resistance. Various causes have been implicated in clopidogrel resistance and alternative therapies are recommended. The aim of this review is to evaluate possible mechanisms, its clinical relevance and alternative treatments of this significant issue.
Güray
Yeşim
Y
Türkiye Yüksek Ihtisas Eğitim ve Araştirma Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye. yesimguray@gmail.com
Güray
Umit
U
Korkmaz
Sule
S
D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D003328:Coronary Thrombosis / Q000188:drug therapy*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin