Description of Response to Aspirin and Clopidogrel in Outpatients With Coronary Artery Disease Using Multiple Electrode Impedance Aggrego metry

Gerotziafas, Grigoris T. MD, PhD
Zarifìs, John MD, PhD
Bandi, Anastasia MD
Mossialos, Lambros MD
Galea, Vasso MD
Tsinopoulos, George MD
Chaari, Mourad Pharmacist
Baccouche, Hela MD
Sassi, Mouna Pharmacist
Elalamy, Ismail MD, PhD

¹Service d'Hématologie Biologique, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France ²ER2 UPMC, Faculté de Médecine, UPMC, Paris VI, France ³First Department of Cardiology, Papanikolaou Hospital, Thessaloniki, Greece ⁴Research Unit on Thrombosis and Vascular Biology, Papageorgiou General Hospital, Thessaloniki Greece ⁵Department of Cardiology, Papageorgiou Hospital, Thessaloniki, Greece

Corresponding Author:

Grigoris T. Gerotziafas, Service d'Hématologie Biologique, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, Cedex 20, France Email: [email protected]

Clinical & Applied Thrombosis/Hemostasis 18(4):p 356-363, July-August 2012. | DOI: 10.1177/1076029611429122

Abstract

Identification of outpatients with high platelet reactivity (HPR) on antiplatelet treatment is an unmet need. The present study was conducted in healthy individuals (n = 50) and in outpatients with coronary artery disease (CAD) at a distance from the acute ischemic episode (aspirin group, n = 71; aspirin/clopidogrel group, n = 106). We studied the feasibility and the precision of whole blood multiple electrode aggregometry (MEA) after triggering platelet aggregation by arachidonic acid or adenosine diphospate (ADP). The MEA can be performed on whole blood within 2 hours after sample venipuncture. The threshold for the diagnosis of HPR is situated at 55 and 50 U for the arachidonic acid and ADP test, respectively. Frequency of HPR was 7% and 20% in aspirin and aspirin/clopidogrel groups, respectively. In 3.8% of patients in aspirin/clopidogrel group, combined HPR on aspirin and clopidogrel was found. In outpatients with CAD, use of MEA is feasible for the diagnosis of HPR.