title: Antiplatelet drug resistance in patients with recurrent acute coronary syndrome undergoing conservative management.
abstract: OBJECTIVE
  Recurrent ischemic events continue to occur despite combination anti-platelet therapy. Currently aspirin, clopidogrel and dual resistance are increasingly recognized entities. The relationship of such resistance to recurrent ischemic events is largely unknown. In this study, we tried to gain an insight into the role of antiplatelet drug resistance with recurrent Acute Coronary Syndrome (ACS).
  
  
  METHODS
  The antiplatelet effect of aspirin and clopidogrel was studied in 40 recurrent ACS patients and 170 patients with first episode of ACS, after > or = 7 days of dual antiplatelet therapy. Platelet aggregation study was done with optical aggregometer. Resistance to aspirin and clopidogrel was defined as > or = 50% aggregation with collagen and ADP respectively.
  
  
  RESULTS
  Aspirin, clopidogrel and dual drug resistance were encountered respectively in 35%, 72.5% and 32.5% patients with recurrent ACS. The corresponding figures for the patients with first episode of ACS were 25.3%, 42.3% and 18.8% respectively. P values for the comparisons were 0.237 for aspirin, 0.0007 for clopidogrel and 0.084 for dual drugs. Patients with recurrent ACS were relatively younger and had a higher prevalence of conventional risk factors like hypertension, diabetes and elevated LDL.
  
  
  CONCLUSIONS
  Antiplatelet drug resistance is likely to play an important role in recurrent ACS alongside other conventional risk factors. Further research is required in this field to have a definitive conclusion.
authors.affiliation: Department of Cardiology, Medical College, Kolkata, West Bengal, India. guhas55@hotmail.com
authors.forename: Santanu
authors.initials: S
authors.lastname: Guha
authors.forename: Soura
authors.initials: S
authors.lastname: Mookerjee
authors.forename: Pradipta
authors.initials: P
authors.lastname: Guha
authors.forename: Partha
authors.initials: P
authors.lastname: Sardar
authors.forename: Suryyani
authors.initials: S
authors.lastname: Deb
authors.forename: Puspita Das
authors.initials: PD
authors.lastname: Roy
authors.forename: Rathindranath
authors.initials: R
authors.lastname: Karmakar
authors.forename: Siddhartha
authors.initials: S
authors.lastname: Mani
authors.forename: M B
authors.initials: MB
authors.lastname: Hema
authors.forename: Santasil
authors.initials: S
authors.lastname: Pyne
authors.forename: Prantar
authors.initials: P
authors.lastname: Chakraborti
authors.forename: P K
authors.initials: PK
authors.lastname: Deb
authors.forename: Prabir
authors.initials: P
authors.lastname: Lahiri
authors.forename: Utpal
authors.initials: U
authors.lastname: Chaudhuri
mesh_terms: D054058:Acute Coronary Syndrome; D000328:Adult; D000077144:Clopidogrel; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D010979:Platelet Function Tests; D012008:Recurrence; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine