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Title

Prevalence of poor biological response to clopidogrel: a systematic review

Authors
Mallouk, Nora
Labruyère, Carine
Chapelle, Céline
Piot, Michèle
Gris, Jean-Christophe
Delavenne, Xavier
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Published in Thrombosis and Haemostasis. 2012, vol. 107, no. 3, p. 494-506
Abstract The existence of poor biological response to clopidogrel has been shown in some patients. Despite the increasing number of studies, this phenomenon remains difficult to quantify. We performed a systematic review to estimate the prevalence of poor biological response to clopidogrel and investigate the factors known to modulate this. An exhaustive search was performed. Altogether 171 publications were identified, providing data for a total of 45,664 subjects. The estimated prevalence of poor biological response to clopidogrel ranged from 15.9% to 49.5% according to the platelet function assay employed. The assays most frequently used were light transmittance aggregometry (LTA), the vasodilator-stimulated phosphoprotein (VASP) assay and the Verifynow® assay. For all these assays, higher cut-off values were associated with a lower prevalence of poor biological response to clopidogrel. However, when choosing a fixed cut-off point for each assay, the prevalence of poor biological response to clopidogrel was highly variable suggesting that other factors could modulate poor biological response to clopidogrel. Finally, none of the studied factors could apparently explain the variability of poor biological response to clopidogrel. This meta-analysis shows that the prevalence of poor biological response depends on the assay employed, the cut-off value and on various unidentified additional factors.
Keywords HumansMyocardial Ischemia/diagnosis/drug therapy/epidemiologyObserver VariationPlatelet Aggregation Inhibitors/therapeutic usePlatelet Function Tests/standards/statistics & numerical dataPrevalenceReceptorsPurinergic P2Y12/metabolismReference StandardsTiclopidine/analogs & derivatives/therapeutic useTreatment Failure
Identifiers
PMID: 22273694
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Article (Published version) (1.2 MB) - document accessible for UNIGE members only Limited access to UNIGE
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Research group Geneva Platelet Group (13)
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MALLOUK, Nora et al. Prevalence of poor biological response to clopidogrel: a systematic review. In: Thrombosis and Haemostasis, 2012, vol. 107, n° 3, p. 494-506. https://archive-ouverte.unige.ch/unige:26333

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Deposited on : 2013-02-11

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