Chronic kidney disease is associated with clopidogrel low responsiveness in acute coronary syndrome subsets

Uluslararası Katılımlı 30. Türk Kardiyoloji Kongresi, Antalya, Türkiye, 23 - 26 Ekim 2014, ss.1, (Özet Bildiri)

Background: Variability of platelet response to antiplatelet therapy is a multifactorial phenomenon, and the

underlying mechanisms are of a nongenetic and genetic nature. Chronic renal failure (CRF) is a common

comorbidity of patients with acute coronary syndrome (ACS), and may influence the response to antiplatelet

therapy. The aim of this study was to investigate the effects on CRF on clopiodgrel responsiveness among

ACS subsets.

Methods: This was a cross-sectional observational study in which ACS patients recieving aspirin and clopidogrel

therapy were studied. Patients were categorized into 2 groups according to the presence or absence

of moderate/ severe CKD. The ADP-induced platelet aggregation was assessed in whole blood with MEA on

a Multiplate analyzer (Dynabyte, Munich, Germany).

Results: A total of 207 ACS patients were analyzed. Patients with moderate/severe CKD (n = 51) had significantly

higher ADP-induced (352.49± 210.15 60 vs. 273.68± 144.10, p=0.001) platelet aggregation compared

with those without (n = 156). After adjustment for potential confounders, patients with moderate/severe CRF

were more likely to have clopidogrel low responsiveness (adjusted odds ratio: 2.5, 95% confidence interval:

1.02 to 6.23, p = 0.04).

Conclusions: In ACS patients taking aspirin and clopidogrel therapy, CRF is associated with reduced clopidogrel-

induced antiplatelet effects.