Reference

Clopidogrel resistance

All Rights Reserved. Clopidogrel resistance. Geisler, Tobias; Gawaz, Meinrad (Medizinische Klinik III, Eberhard-Karls-Universitaet, Tuebingen, Germany). Laboratoriumsmedizin, 30(5), 310-316 (English) 2006 Walter de Gruyter GmbH & Co. KG. CODEN: LABOD3. ISSN: 0342-3026. DOCUMENT TYPE: Journal; General Review CA Section: 1 (Pharmacology) A review. Clopidogrel as a thienopyridine is a potent antiplatelet drug blocking the P2Y12 ADP receptor. Clopidogrel resistance can be regarded as missing pharmacol. effect or as the incidence of atherothrombotic events despite antiplatelet therapy. However, clear definitions are still lacking.Several substances with their cas registry numbers 150322-43-3 and 336874-97-6 may be metioned in this study. The incidence is dependent on the type of platelet function assay. ADP-induced aggregation, flow cytometric quantification of platelet activation markers, the degree of phosphorylization of vasodilator-stimulated phosphoprotein, or even bedside tests are used to measure the pharmacol. effect of clopidogrel. Current data show that 4 to 30% of patients treated by coronary stenting do not adequately respond to clopidogrel treatment and are therefore at increased risk for subacute stent-thrombosis. Variants of cytochrome P3A5 and ADP receptor P2Y12 genotype may influence the response to clopidogrel. As first clin. studies demonstrated, low response to clopidogrel is indeed assocd. with future cardiovascular events. A promising approach to over-come clopidogrel resistance could be a higher loading dose, an increased maintenance dose, or the application of alternative thienopyridines such as CD-747 (Prasugrel) or non-thienopyridine P2Y12 antagonists. .

Prasugrel

All Rights Reserved. Prasugrel. Tantry, Udaya S.; Bliden, Kevin P.; Gurbel, Paul A. (Hoffberger Building, Sinai Center for Thrombosis Research, Baltimore, MD 21215, USA). Expert Opinion on Investigational Drugs, 15(12), 1627-1633 (English) 2006 Informa Healthcare. CODEN: EOIDER. ISSN: 1354-3784. DOCUMENT TYPE: Journal; General Review CA Section: 1 (Pharmacology) Section cross-reference(s): 63 A review. Clin. trials have demonstrated the superior clin. efficacy of dual antiplatelet therapy with a thienopyridine (a P2Y12 receptor blocker) and aspirin (COX-1 inhibitor) in patients undergoing stenting as well as patients with acute coronary syndromes. However, clopidogrel treatment is assocd. with a wide response variability and non-responsiveness in selected patients. The latter phenomenon is linked to the occurrence of recurrent ischemic events including stent thrombosis in the recent studies. Prasugrel is a new thienopyridine deriv. that produces more potent platelet inhibition and a rapid onset of action that is assocd. with irreversible P2Y12 receptor blockade. The latter properties of prasugrel may provide a superior alternative to clopidogrel, with less response variability and a decreased prevalence of non-responsiveness.Except for chemicals metioned above, 150322-43-3 is also used. .