CLOPIDOGREL RESISTANCE AND ITS RELATION WITH AGE AND GENDER

Introduction/Objective:  Clopidogrel is an antiplatelet drug used for ischemic heart disease patients, but it is not equally effective in all the patients due to clopidogrel resistance. Clopidogrel resistance is a precursor to secondary adverse cardiac events. This study was conducted to assess the magnitude of clopidogrel resistance in Pakistan and to find its association with age and gender. Methodology: This was a cross sectional study conducted from 2015-2017 at Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan. We included 390 ischemic heart disease patients, who were taking clopidogrel 75 mg/day for at least 7 days. Blood samples of all these patients were taken and platelet aggregation studies were performed with the help of light transmission aggregometer using adenosine diphosphate as an agonist. Results: Our study demonstrates that 75.1% of the patients were clopidogrel responders while 24.9% patients were clopidogrel resistant. Mean platelet aggregation of clopidogrel resistant patients was significantly higher than clopidogrel responders (60.22 ± 7.33% vs 27.73 ± 12.17%), p<0.001. There was no effect of age and gender on clopidogrel response status with p=0.266 and p=0.860 respectively. There was no difference in mean platelet aggregation of both genders (p=0.532) and among different age groups (p=0.234). Conclusion: Clopidogrel resistance is quite common in Pakistan affecting as much as quarter of local population and it is not specific to any age group or gender.  Pak J Physiol 2019;15(1):25-8