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CLOPIDOGREL THERAPY FOLLOWING CORONARY ARTERY STENTING IN ACUTE CORONARY SYNDROME PATIENTS

Dr. Muhammad Saqib Hissan, Dr. Sabah Ashraf, Dr. Muhammad Talha Saeed.

Background: Antiplatelet therapy prescribed in combination has been in practice all over the globe. The non-respondents are then put on interventional procedures like coronary artery stenting. Aspirin and clopidogrel 300mg each are used as anti-ischemic in patients with acute coronary syndrome. Objective: The aim of study is to find resistance of clopidogrel after coronary artery intervention. Methods: Study was conducted at department of cardiology, Mayo Hospital, Lahore, Pakistan. Study duration was one year from June 2016 to July 2017. 4 to 6 hours before PCI all patients were given 600mg clopidogrel and later were advised clopidogrel and aspirin 75mg each. A blocking analysis test was performed on P2Y12 after collecting venous blood sample. Test results were categorized into resistant, hypo-reactive and receiver based on closing time, <106 seconds, between 106 to 224seconds and >225 seconds, respectively. Demographic profile and risk factors for ACS were inquired from all participants. Results: Total study population was 50 patients who were to undergo PCI including 38 males and 12 females. Fifteen were resistant (30%), 5 were hypo-reactive (10%), 30 were receivers (60%). All patients remained free from any coronary event till 4 weeks after PCI. Conclusion: More than one third of post PCI population was resistant or hypo-reactive to clopidogrel. Keywords: Clopidogrel, resistance, percutaneous coronary intervention (PCI), P2Y12 platelet aggregation.

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