Low responsiveness to clopidogrel increases risk among CKD patients undergoing coronary intervention

Patrik Htun, Suzanne Fateh-Moghadam, Christian Bischofs, Winston Banya, Karin Müller, Boris Bigalke, Konstantinos Stellos, Andreas E May, Marcus Flather, Meinrad Gawaz, Tobias Geisler

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69 Citations (Scopus)

Abstract

Patients with CKD are at higher risk for major events after percutaneous coronary intervention (PCI) compared with subjects with normal renal function. The aims of this study were to evaluate responsiveness to clopidogrel in patients with CKD and to examine the effect of antiplatelet drug response on post-PCI outcome. We retrospectively evaluated a consecutive cohort of 1567 patients with symptomatic coronary artery disease undergoing PCI, 648 (41%) of whom had stage 3 to 5 CKD. We assessed responsiveness to clopidogrel by ADP-induced platelet aggregation after oral administration of a 600-mg clopidogrel loading dose and 100 mg of aspirin. In a multivariate survival analysis that included 1335 (85%) of the cohort, stage 3 to 5 CKD and low response to clopidogrel were independent predictors of the primary end point (composite of myocardial infarction, ischemic stroke, and death within 1 year). In summary, a low response to clopidogrel might be an additional risk factor for the poorer outcomes in patients with stage 3 to 5 CKD compared with patients with better renal function.
Original languageEnglish
Pages (from-to)627-33
Number of pages7
JournalJournal of the American Society of Nephrology
Volume22
Issue number4
DOIs
Publication statusPublished - Apr 2011

Keywords

  • Aged
  • Angioplasty, Balloon, Coronary
  • Aspirin
  • Chronic Disease
  • Cohort Studies
  • Coronary Artery Disease
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Hemorrhage
  • Humans
  • Kidney Diseases
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors
  • Retrospective Studies
  • Risk Factors
  • Ticlopidine
  • Treatment Outcome

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