title: [Clopidogrel resistance in cerebrovascular disease -- results of one-year follow-up].
abstract: BACKGROUND
  In an earlier study the authors reported short-term benefits of clopidogrel treatment in patients with cerebrovascular disease.
  
  
  OBJECTIVE
  The aim of the authors was to analyze findings during a 12-month follow-up period.
  
  
  METHODS
  100 patients with a history of acute stroke or transient ischaemic attack have been included in the study. The efficacy of the therapy was assessed 7 and 28 days as well as 3, 6 and 12 months after initiation of medical therapy. Patients were divided into two parts (clopidogrel responder and resistant) based on their initial laboratory findings. Risk profiles, medical therapy, laboratory parameters and vascular events were compared between the two patient groups.
  
  
  RESULTS
  After 7 days of treatment, clopidogrel seemed to be ineffective in 11 patients (11%). Strong, clinically significant correlations were found among blood pressure values, blood glucose and lipid parameters, serum C-reactive protein levels and platelet aggregation levels. An aggressive secondary preventive therapy resulted in a decrease of clopidogrel resistance and improvement in laboratory parameters. Patients who were clopidogrel resistant at baseline had significantly higher rate of vascular events compared to those who were clopidogrel responders (18.1 vs. 4.5%, p<0.01), although clopidogrel resistance was not an independent risk factor of unfavourable vascular outcome using a multivariate analysis. No adverse events or hemorrhagic complications were observed.
  
  
  CONCLUSIONS
  Clopidogrel resistance and unfavourable outcome seems to be associated with "classical" risk factors underlying the importance of aggressive secondary prevention.
authors.affiliation: Pécsi Tudományegyetem, Általános Orvostudományi Kar Neurológiai Klinika Pécs.
authors.forename: László
authors.initials: L
authors.lastname: Szapáry
authors.affiliation: Pécsi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Pécs.
authors.forename: Katalin
authors.initials: K
authors.lastname: Koltai
authors.affiliation: Pécsi Tudományegyetem, Általános Orvostudományi Kar Foglalkozás-egészségügyi és Munkahigiénés Központ Pécs.
authors.forename: Antal
authors.initials: A
authors.lastname: Tibold
authors.affiliation: Tolna Megyei Balassa János Kórház I. Belgyógyászati Osztály Szekszárd.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fehér
authors.affiliation: Tolna Megyei Balassa János Kórház Sebészeti Osztály Szekszárd.
authors.forename: Gábor
authors.initials: G
authors.lastname: Harang
authors.affiliation: Pécsi Tudományegyetem, Általános Orvostudományi Kar Neurológiai Klinika Pécs.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Pusch
authors.affiliation: Szigetvári Kórház Neurológiai Osztály Szigetvár.
authors.forename: Gergely
authors.initials: G
authors.lastname: Fehér
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D000077144:Clopidogrel; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy* / Q000517:prevention & control; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods; D020521:Stroke / Q000188:drug therapy* / Q000517:prevention & control; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D008055:Lipids; D010975:Platelet Aggregation Inhibitors; D002097:C-Reactive Protein; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: aggregometria; aggregometry; clinical outcome; clopidogrel; klinikai kimenetel; resistance; rezisztencia; vascular prevention; vascularis prevenció