Bilal S Mohydin, Faiza Bashir, Sajjad Ahmad, Ayesha Hameed, Shabana Azim, Bilal Zakariah Khan.
Coronary intervention and clopidogrel resistance –a local experience.
J Cardiovascular Dis Jan ;11(1):14-8.

BACKGROUND: Dual antiplatelet therapy (DAP) is the cornerstone managing coronary artery : disease in the current era of coronary interventions. The pattern of resistance to Clopidogrel . in our population is not known. The objective of this study was to assess the frequency of resistance / hypo-responsiveness to Clopidogrel after percutaneous coronary intervention (PCI) in Pakistani population. METHODS: The study was done at : Punjab Institute of Cardiology over a period of 5 months in 2012-13. After informed consent, patients who underwent PCI 4 weeks earlier were enrolled. All patients had recieved 600mg of Clopidogrel 4 to 6 hours before PCI and were taking Aspirin 75mg and Clopidogrel 75mg twice daily in addition to their routine medicine. Venous blood samples of all selected patients were collected and P2Y12 blockade analysis test was performed. The test has a “Closure Time” measured in seconds. Patients were labelled, on the basis of this Time, as resistant (closure time < 106 seconds), hypo-responsive (closure time 106 to 224 seconds), and responsive (closure time > 225 seconds). Demographic data and coronary risk factors wre noted for all patients. Results: Results: Fifty patients (38 men and 12 women) were studied Results: . Fifteen (30%) patients were . resistant to Clopidogrel, 5 (10%) were hyporespnsive and 30 (60%) were fully responsive as per closure time criteria. None of them suffered a clinically evident coronay event during 4 weeks post PCI. CONCLUSION: More than 1/3rd of our post PCI patients are likely to be resistant or hypo- : responsive to Clopidogrel.

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