Scientific article
English

Prevalence of poor biological response to clopidogrel: a systematic review

Published inThrombosis and haemostasis, vol. 107, no. 3, p. 494-506
Publication date2012
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
  • Humans
  • Myocardial Ischemia/diagnosis/drug therapy/epidemiology
  • Observer Variation
  • Platelet Aggregation Inhibitors/therapeutic use
  • Platelet Function Tests/standards/statistics & numerical data
  • Prevalence
  • Receptors
  • Purinergic P2Y12/metabolism
  • Reference Standards
  • Ticlopidine/analogs & derivatives/therapeutic use
  • Treatment Failure
Citation (ISO format)
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. doi: 10.1160/TH11-03-0202
Main files (1)
Article (Published version)
accessLevelRestricted
Identifiers
Journal ISSN0340-6245
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Creation11/06/2012 4:28:00 PM
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