ASSOCIATION OF BODY MASS INDEX WITH CLOPIDOGREL RESISTANCE

Background: Clopidogrel is an essential component of dual antiplatelet treatment for ischemic heart disease. We planned to explore the association of body mass index with clopidogrel resistance in ischemic heart disease patients. Methods: Three hundred and ninety patients of ischemic heart disease who were taking clopidogrel 75mg/day, were included in the study. Patients were categorized according to their body mass index (BMI) into underweight (BMI 25 Kg/m2). Their blood samples were taken and platelet aggregation studies were performed using Chronolog light transmission aggregometer to confirm clopidogrel resistant status. Results: None of the underweight, 19.50% of the normal weight, 24.20% of the overweight and 33.60% of the obese patients were found to be clopidogrel resistant. Clopidogrel resistance was significantly higher in obese patients as compared to normal weight patients, p=0.019. No significant difference in clopidogrel response was found between normal weight and overweight patients, as well as overweight and obese patients. Mean BMI of clopidogrel resistant patients was significantly higher than mean BMI of clopidogrel responders (26.46±3.82 vs 24.15±3.39 Kg/m2), p<0.001. Correlation between BMI and platelet aggregation was significant (p<0.001, r=0.20). Conclusion: BMI is inversely related to the platelet inhibition by clopidogrel. Higher BMI is related to clopidogrel resistance in ischemic heart disease patients.