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ORIGINAL ARTICLE
Year : 2020  |  Volume : 2  |  Issue : 1  |  Page : 36-41

Antiplatelet drug resistance in Indians


1 Department of Cardiology, Nizar Cardiac Center, Malapuram, Kerala, India
2 Department of Cardiology, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India
3 Society for Continuing Medical Education and Research, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India

Correspondence Address:
Prof. G Vijayaraghavan
KIMS, Thiruvananthapuram, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ACCJ.ACCJ_6_20

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Background and Objectives: Resistance to the antiplatelet drugs aspirin and clopidogrel is well recognized, and its prevalence has been reported from many countries. There is, however, a paucity of reports on the prevalence of resistance to these drugs in Indian patients. This information is important as resistance to one or both of these drugs may play a role in-stent thrombosis and post angioplasty complications while using drug-eluting stents. The present study was conducted in 200 consecutive patients with myocardial infarction (MI) who underwent elective percutaneous coronary intervention in a single center and who gave consent for the study. The objective of the study was to determine the prevalence of aspirin and clopidogrel resistance in Indian patients who were administrated either of the drugs after PCI, using the VerifyNow P2Y12 assay. Methods: All patients were evaluated on day 7 after the procedure, and blood was collected in the laboratory and immediately analyzed. Platelete resistance to aspirin and clopidogrel was determined by verifying now RPFT point of the care system. Asprin resistance was measured as Aspirin Reaction Unit (ARU); >550 ARU was considered as aspirin resistance. Clopidogrel resistance was considered when Platelet Reaction Unit (PRU) was >213. Results: Among the 200 patients with MI, 87% were males and 13% were female. Their age group varied from 35 to 83 years. Among the study participants, 22% were resistant to an aspirin dose of 150 mg orally and the remaining 78% had normal platelet aggregation. About 68% were sensitive to clopidogrel, and 32% were resistant. About 58% of females were resistant to aspirin as against 29% of male patients, and 38% of females were resistant to clopidogrel as against 18% of male patients. Further, aspirin and clopidogrel were not associated with age and diabetes mellitus (P ≥ 0.05). Conclusions: The prevalence of aspirin and clopidogrel resistance in India is similar to those reported from the United States of America and Europe. The resistance pattern was also found to be similar.


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