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<meta name="DC.Title" content="Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting" />
<meta name="DC.Identifier" content="10.3174/ajnr.A0818" />
<meta name="DC.Date" content="2008-02-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The prevalence of antiplatelet drug resistance among patients who undergo cerebrovascular stent placement is unknown. We aimed to assess the feasibility of monitoring antiplatelet drug effects in a single-center cohort undergoing cerebrovascular stent placement.

MATERIALS AND METHODS: We prospectively collected medical, laboratory, and radiographic data on patients who underwent cerebrovascular stent placement. We used the rapid platelet function assay-aspirin (RPFA-ASA) to calculate aspirin reaction units (ARU) and the P2Y12 assay to calculate P2Y12 reaction units and percentage platelet inhibition. Aspirin resistance was defined as ARU &gt; 550, whereas clopidogrel resistance was defined as percentage platelet inhibition &lt; 40%.

RESULTS: Among 76 patients, stent indications were the following: wide-neck aneurysm (57, 75.0%), symptomatic intracranial stenosis (12, 15.7%), carotid stenosis (5, 6.6%), and vertebral stenosis (2, 2.6%). For aspirin, the median dosage per week was 1300 mg and median ARU was 410. Among 71 patients on aspirin, 3 patients (4.2%) were resistant; there was a significant inverse correlation between aspirin dose and ARU ( r = −0.31, P = .01). Among 55 patients on clopidogrel, the median dosage per week was 525 mg with a mean platelet inhibition of 43.2%. Twenty-eight patients (51.9%) were clopidogrel-resistant. In a multivariable linear regression model, age older than 55 years (b = −16.3, P = .020) and diabetes (b = −26.8, P = .015) were inversely related to percentage platelet inhibition.

CONCLUSIONS: Using point-of-care tests, we found that aspirin resistance is relatively uncommon, whereas clopidogrel resistance occurred in half of patients undergoing cerebrovascular stent placement. Further studies should focus on ideal doses, timing, and duration of antiplatelet therapy for cerebrovascular stent placement." />
<meta name="DC.Contributor" content="S. Prabhakaran" />
<meta name="DC.Contributor" content="K.R Wells" />
<meta name="DC.Contributor" content="V.H. Lee" />
<meta name="DC.Contributor" content="C.A. Flaherty" />
<meta name="DC.Contributor" content="D.K. Lopes" />
<meta name="article:published_time" content="2008-02-01" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; The prevalence of antiplatelet drug resistance among patients who undergo cerebrovascular stent placement is unknown. We aimed to assess the feasibility of monitoring antiplatelet drug effects in a single-center cohort undergoing cerebrovascular stent placement.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; We prospectively collected medical, laboratory, and radiographic data on patients who underwent cerebrovascular stent placement. We used the rapid platelet function assay-aspirin (RPFA-ASA) to calculate aspirin reaction units (ARU) and the P2Y12 assay to calculate P2Y12 reaction units and percentage platelet inhibition. Aspirin resistance was defined as ARU &amp;gt; 550, whereas clopidogrel resistance was defined as percentage platelet inhibition &amp;lt; 40%.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; Among 76 patients, stent indications were the following: wide-neck aneurysm (57, 75.0%), symptomatic intracranial stenosis (12, 15.7%), carotid stenosis (5, 6.6%), and vertebral stenosis (2, 2.6%). For aspirin, the median dosage per week was 1300 mg and median ARU was 410. Among 71 patients on aspirin, 3 patients (4.2%) were resistant; there was a significant inverse correlation between aspirin dose and ARU (&lt;i&gt;r&lt;/i&gt; = −0.31, &lt;i&gt;P&lt;/i&gt; = .01). Among 55 patients on clopidogrel, the median dosage per week was 525 mg with a mean platelet inhibition of 43.2%. Twenty-eight patients (51.9%) were clopidogrel-resistant. In a multivariable linear regression model, age older than 55 years (b = −16.3, &lt;i&gt;P&lt;/i&gt; = .020) and diabetes (b = −26.8, &lt;i&gt;P&lt;/i&gt; = .015) were inversely related to percentage platelet inhibition.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS:&lt;/b&gt; Using point-of-care tests, we found that aspirin resistance is relatively uncommon, whereas clopidogrel resistance occurred in half of patients undergoing cerebrovascular stent placement. Further studies should focus on ideal doses, timing, and duration of antiplatelet therapy for cerebrovascular stent placement.&lt;/p&gt;" />
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<meta name="twitter:title" content="Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The prevalence of antiplatelet drug resistance among patients who undergo cerebrovascular stent placement is unknown. We aimed to assess the feasibility of monitoring antiplatelet drug effects in a single-center cohort undergoing cerebrovascular stent placement.

MATERIALS AND METHODS: We prospectively collected medical, laboratory, and radiographic data on patients who underwent cerebrovascular stent placement. We used the rapid platelet function assay-aspirin (RPFA-ASA) to calculate aspirin reaction units (ARU) and the P2Y12 assay to calculate P2Y12 reaction units and percentage platelet inhibition. Aspirin resistance was defined as ARU &gt; 550, whereas clopidogrel resistance was defined as percentage platelet inhibition &lt; 40%.

RESULTS: Among 76 patients, stent indications were the following: wide-neck aneurysm (57, 75.0%), symptomatic intracranial stenosis (12, 15.7%), carotid stenosis (5, 6.6%), and vertebral stenosis (2, 2.6%). For aspirin, the median dosage per week was 1300 mg and median ARU was 410. Among 71 patients on aspirin, 3 patients (4.2%) were resistant; there was a significant inverse correlation between aspirin dose and ARU ( r = −0.31, P = .01). Among 55 patients on clopidogrel, the median dosage per week was 525 mg with a mean platelet inhibition of 43.2%. Twenty-eight patients (51.9%) were clopidogrel-resistant. In a multivariable linear regression model, age older than 55 years (b = −16.3, P = .020) and diabetes (b = −26.8, P = .015) were inversely related to percentage platelet inhibition.

CONCLUSIONS: Using point-of-care tests, we found that aspirin resistance is relatively uncommon, whereas clopidogrel resistance occurred in half of patients undergoing cerebrovascular stent placement. Further studies should focus on ideal doses, timing, and duration of antiplatelet therapy for cerebrovascular stent placement." />
<meta name="og-title" property="og:title" content="Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting" />
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<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The prevalence of antiplatelet drug resistance among patients who undergo cerebrovascular stent placement is unknown. We aimed to assess the feasibility of monitoring antiplatelet drug effects in a single-center cohort undergoing cerebrovascular stent placement.

MATERIALS AND METHODS: We prospectively collected medical, laboratory, and radiographic data on patients who underwent cerebrovascular stent placement. We used the rapid platelet function assay-aspirin (RPFA-ASA) to calculate aspirin reaction units (ARU) and the P2Y12 assay to calculate P2Y12 reaction units and percentage platelet inhibition. Aspirin resistance was defined as ARU &gt; 550, whereas clopidogrel resistance was defined as percentage platelet inhibition &lt; 40%.

RESULTS: Among 76 patients, stent indications were the following: wide-neck aneurysm (57, 75.0%), symptomatic intracranial stenosis (12, 15.7%), carotid stenosis (5, 6.6%), and vertebral stenosis (2, 2.6%). For aspirin, the median dosage per week was 1300 mg and median ARU was 410. Among 71 patients on aspirin, 3 patients (4.2%) were resistant; there was a significant inverse correlation between aspirin dose and ARU ( r = −0.31, P = .01). Among 55 patients on clopidogrel, the median dosage per week was 525 mg with a mean platelet inhibition of 43.2%. Twenty-eight patients (51.9%) were clopidogrel-resistant. In a multivariable linear regression model, age older than 55 years (b = −16.3, P = .020) and diabetes (b = −26.8, P = .015) were inversely related to percentage platelet inhibition.

CONCLUSIONS: Using point-of-care tests, we found that aspirin resistance is relatively uncommon, whereas clopidogrel resistance occurred in half of patients undergoing cerebrovascular stent placement. Further studies should focus on ideal doses, timing, and duration of antiplatelet therapy for cerebrovascular stent placement." />
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      <h1 class="highwire-cite-title" id="page-title">Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S. Prabhakaran</span>, <span class="highwire-citation-author" data-delta="1">K.R Wells</span>, <span class="highwire-citation-author" data-delta="2">V.H. Lee</span>, <span class="highwire-citation-author" data-delta="3">C.A. Flaherty</span> and <span class="highwire-citation-author" data-delta="4">D.K. Lopes</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2008,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">281-285; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A0818 </span></div>
  
  
  
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      <div class="highwire-cite-title">Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Prabhakaran</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">K.R</span> <span class="nlm-surname">Wells</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">V.H.</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">C.A.</span> <span class="nlm-surname">Flaherty</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">D.K.</span> <span class="nlm-surname">Lopes</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2008, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">281-285; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0818 </span></div>
  
  
  
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      <div class="highwire-cite-title">Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Prabhakaran</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">K.R</span> <span class="nlm-surname">Wells</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">V.H.</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">C.A.</span> <span class="nlm-surname">Flaherty</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">D.K.</span> <span class="nlm-surname">Lopes</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2008, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">281-285; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0818 </span></div>
  
  
  
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