Choi Ho, Ryu JiHyeon, Seo Heenam, Kang MinKu, Kim Eunyoung
Department of Pharmacy, Sun Hospital, Daejeon, South Korea.
Clinical Pharmacy and Evidence Based Practice Research Lab, College of Pharmacy, ChungAng University, Seoul, 156-756, South Korea.
Int J Clin Pharm. 2015 Oct;37(5):758-61. doi: 10.1007/s11096-015-0118-z. Epub 2015 Apr 17.
A double maintenance dose of clopidogrel at 150 mg daily has been suggested as an effective alternative treatment for patients who have clopidogrel resistance.
To determine if a double maintenance dose of clopidogrel can overcome the low drug response rate observed in patients who have clopidogrel resistance while on a 75 mg daily standard maintenance dose of clopidogrel.
A retrospective analysis was conducted in South Korean patients who underwent a platelet function test and received a double maintenance dose of clopidogrel at a secondary medical institution between January 2011 and June 2012. The primary endpoint was to assess clopidogrel response using an adenosine diphosphate test after a double maintenance dose of clopidogrel. The secondary endpoint was the presence of factors that could affect response to clopidogrel.
Of 389 patients identified, 77 patients were eligible for this study. Values from the adenosine diphosphate test decreased significantly in 63 patients (82%) after a double maintenance dose of clopidogrel (p < 0.001). A total of 37 patients (48%) overcame clopidogrel resistance. Concurrent disease appeared to be a contributory factor in clopidogrel resistance.
A double maintenance dose of clopidogrel at 150 mg daily was associated with a reduction in adenosine diphosphate-induced platelet aggregation in South Korean patients who previously exhibited clopidogrel resistance.
对于存在氯吡格雷抵抗的患者，建议每日给予150毫克氯吡格雷双倍维持剂量作为一种有效的替代治疗方法。
确定氯吡格雷双倍维持剂量是否能够克服在接受每日75毫克氯吡格雷标准维持剂量时出现氯吡格雷抵抗的患者中观察到的低药物反应率。
对2011年1月至2012年6月期间在一家二级医疗机构接受血小板功能测试并接受氯吡格雷双倍维持剂量的韩国患者进行回顾性分析。主要终点是在氯吡格雷双倍维持剂量后使用二磷酸腺苷试验评估氯吡格雷反应。次要终点是可能影响氯吡格雷反应的因素的存在情况。
在确定的389例患者中，77例符合本研究条件。在氯吡格雷双倍维持剂量后，63例患者（82%）的二磷酸腺苷试验值显著降低（p < 0.001）。共有37例患者（48%）克服了氯吡格雷抵抗。并发疾病似乎是氯吡格雷抵抗的一个促成因素。
对于先前表现出氯吡格雷抵抗的韩国患者，每日150毫克氯吡格雷双倍维持剂量与二磷酸腺苷诱导的血小板聚集减少有关。
