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Detection of Clopidogrel Hyporesponsiveness Using a Point-of-Care Assay and the Impact of Additional Cilostazol Administration after Coronary Stent Implantation in Diabetic Patients

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Author(s)
Tae-Hyun YangDoo-Il KimDong-Kie KimJae-Sik JangUng KimSang-Hoon SeolDae-Kyeong KimGeu-Ru HongJong-Seon ParkDong-Gu ShinYoung-Jo KimYun-Kyeong ChoChang-Wook NamSeung-Ho HurKwon-Bae KimDong-Soo Kim
Keimyung Author(s)
Cho, Yun KyeongNam, Chang WookHur, Seung HoKim, Kwon Bae
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Journal of Internal Medicine
Issued Date
2011
Volume
26
Issue
2
Keyword
CilostazolClopidogrelDiabetes mellitusPlatelet function testsPoint-of-care systems
Abstract
Background/Aims

Impaired responsiveness to clopidogrel is common in patients with type 2 diabetes mellitus (DM). The aim of this study was to evaluate the clinical application of a point-of-care assay to detect impaired responsiveness to clopidogrel after coronary stent implantation in patients with type 2 DM.


Methods

We measured P2Y12 reaction units (PRU) with the VerifyNow point-of-care assay in 544 consecutive patients undergoing dual or triple (i.e., dual plus cilostazol) anti-platelet therapy after coronary stent implantation. High platelet reactivity (HPR) was defined as a PRU value ≥ 240.


Results

The mean PRU values were 233.5 ± 83.2 and 190.3 ± 85.5 in patients undergoing dual or triple anti-platelet therapy, respectively (p < 0.001). Patients with DM manifested higher post treatment PRU values (238.3 ± 82.4 vs. 210.8 ± 86.8, p = 0.001) and a higher frequency of HPR (44.8% vs. 31.0%, p = 0.003) as compared to patients without DM. We also found that higher PRU values and a higher frequency of HPR were present in patients with DM who were undergoing both triple and dual anti-platelet therapy. However, the higher post-treatment PRU values observed in patients with DM decreased with triple anti-platelet therapy (219.4 ± 82.5 vs. 247.9 ± 81.1, p = 0.044).


Conclusions

A point-of-care assay can detect elevated platelet reactivity and impaired responsiveness to clopidogrel in patients with type 2 DM. The addition of cilostazol to dual anti-platelet therapy may decrease post-treatment PRU values in patients with type 2 DM.

Keywords: Cilostazol, Clopidogrel, Diabetes mellitus, Platelet function tests, Point-of-care systems
Keimyung Author(s)(Kor)
조윤경
남창욱
허승호
김권배
Publisher
School of Medicine
Citation
Tae-Hyun Yang et al. (2011). Detection of Clopidogrel Hyporesponsiveness Using a Point-of-Care Assay and the Impact of Additional Cilostazol Administration after Coronary Stent Implantation in Diabetic Patients. Korean Journal of Internal Medicine, 26(2), 145–152. doi: 10.3904/kjim.2011.26.2.145
Type
Article
ISSN
1226-3303
DOI
10.3904/kjim.2011.26.2.145
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34570
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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