Clopidogrel non-responsiveness in patients undergoing percutaneous coronary intervention using the VerifyNow test: frequency and predictors

• Published in: European journal of hospital pharmacy. Science and practice 2019-03, Vol.26 (2), p.113-116
• Main Authors: Yaseen, Israa Fadhil, Farhan, Hasan Ali, Abbas, Hassan Mohamed
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Angioplasty; Aspirin; Blood platelets; Body mass index; Cardiovascular disease; clopidogrel non-responsiveness; Diabetes; Drug dosages; Heart attacks; Hematology; Intubation; ischaemic heart fisease; Original; Original article; Patients; percutaneous coronary intervention; Pharmacy; Statins; stent thrombosis; Stents; Thrombosis; verifynow test
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2017-001359

ObjectivesStent thrombosis and death after percutaneous coronary intervention (PCI) can be caused by a phenomenon known as clopidogrel non-responsiveness which has been shown to occur in approximately 5%–44% of patients. We investigated the responsiveness of clopidogrel in an Iraqi series of cases. Our aim was to determine for the first time the frequency and predictors of clopidogrel non-responsiveness among Iraqi patients with ischaemic heart disease undergoing PCI.MethodsThe study was conducted at the Cardiac Catheterization Center, Baghdad Teaching Hospital, Medical City, from January to May 2014, and included patients who presented for PCI. A platelet aggregation test was performed for those patients using the VerifyNow system.ResultsA total of 115 patients (mean age: 58.3±10.1 years; male sex: 73.9%) were included in the study. 18.3% of the study population were clopidogrel non-responders, which was comparable with the results of a Chinese study (20.28%, P=0.796) but contrasted with other reports from Jordan, Brazil and Thailand. The major independent predictive factor for non-responsiveness in our report was diabetes mellitus (OR 5.96, 95% CI 2.23 to 13.71; P=0.001), followed by hypertension (OR 4.135, P=0.035), obesity (OR 3.44, P=0.037) and male sex (OR 3.039, P=0.045). Previous use of clopidogrel (OR 0.17, P=0.02) and younger age (OR 0.72, P=0.026) were identified as protective factors.ConclusionsIn this study, 18.3% of patients were non-responders to clopidogrel and the major independent predictive factors for non-responsiveness were diabetes mellitus, hypertension, obesity and male sex.