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The STIB score: a simple clinical test to predict clopidogrel resistance
- Source :
- Acta Cardiologica : an international journal of cardiology, Vol. 70, no.5, p. 516-521 (2015)
- Publication Year :
- 2015
-
Abstract
- Background High platelet reactivity (HPR) to clopidogrel is associated with an increased risk of ischaemic complications during and after coronary interventions and concerns up to 50% of patients undergoing PCI. Aim of the study The aim of the study was to identify patients with HPR to clopidogrel using bedside clinical information obtained in the Stent Thrombosis In Belgium (STIB) trial. Methods Data on platelet reactivity using the VerifyNow (R) point-of-care assay were obtained in 844 patients undergoing PCI for stable coronary artery disease 12 to 24 hours after a 600-mg loading dose of clopidogrel was given. Demographic, clinical and baseline routine biological tests were obtained and compared with P2Y12 reaction units (PRU). Patients with PRU >230 (HPR) were considered as non-responders to clopidogrel. Results HPR was observed in 424/844 pts. Age, weight, body mass index (BMI), HPR to aspirin, diabetes, renal failure (MDRD 28 kg/m(2) and presence of diabetes were equally associated to predict HPR and can be added to derive a simple score to predict clopidogrel resistance. Although 38.5% of patients without a single clinical predictor still have HPR, 2/3 patients with 2 or 3 risk factors are resistant to clopidogrel. Conclusions STIB HPR score allows identification of patients with a high probability of resistance to clopidogrel based on diabetes, Hb 28 kg/m(2). This bedside clinical test could be useful for the identification of patients in whom another P2Y12 inhibitor should be recommended before and after PCI.
- Subjects :
- Male
Time Factors
Platelet Aggregation
VerifyNow
Drug Resistance
Predictive Value of Test
Comorbidity
coronary disease
Body Mass Index
Decision Support Technique
Hemoglobins
Belgium
Risk Factors
Diabetes Complication
Odds Ratio
Prospective Studies
Angioplasty, Balloon, Coronary
Multivariate Analysi
VerifyNow (R)
Coronary disease
Clopidogrel resistance
General Medicine
Middle Aged
Receptors, Purinergic P2Y12
Clopidogrel
Treatment Outcome
ischaemic event
Point-of-Care Testing
Female
Cardiology and Cardiovascular Medicine
Verifynow®
Human
Blood Platelets
Ticlopidine
Logistic Model
Time Factor
Platelet Function Tests
macromolecular substances
Decision Support Techniques
Diabetes Complications
Predictive Value of Tests
Humans
Hemoglobin
cardiovascular diseases
Angina, Stable
Obesity
Aged
Chi-Square Distribution
Platelet Aggregation Inhibitor
Risk Factor
Bleeding
Biomarker
Purinergic P2Y Receptor Antagonist
bleeding
Ischaemic events
Platelet Function Test
Prospective Studie
ischaemic events
Logistic Models
Multivariate Analysis
Purinergic P2Y Receptor Antagonists
Blood Platelet
Biomarkers
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 00015385
- Volume :
- 70
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Acta cardiologica
- Accession number :
- edsair.doi.dedup.....2a08e3c3f0581a3e59affecec97e226c