Table 4.
Studies on antiplatelet resistance in Indian population with coronary artery disease.
| Reference [Year] |
Patient studied | Place | Dose (mg) | Assay (cut-off for resistance) |
Clinical outcome |
|---|---|---|---|---|---|
|
Sadiq PA et al. (19) 2005 |
Stable CAD (n = 50) |
Lucknow, Uttar Pradesh | Aspirin = 150 mg OD | LTA (Aspirin resistance = mean platelet aggregation of ≥70% with 10 μM ADP and a mean aggregation of ≥20% with 0.5 mg/mL A A Aspirin semi-resistance = Any of above criteria) |
Aspirin resistance = 2.08 % Aspirin semi-responders = 39.58 % Females tended to be more aspirin semi-responsive (p = 0.08) Other risk parameters were not associated with Aspirin resistance |
|
Kumar S et al. (7) 2007 |
ACS (n = 39) |
Lucknow, Uttar Pradesh | Clopidogrel: 300 mg bolus f/b 75 mg OD Aspirin: 325 mg OD |
LTA (Clopidogrel Resistance = <10% decrease from baseline in platelet aggregation with 10 μM ADP Clopidogrel semi-responder= <30% decrease from baseline) |
Clopidogrel resistant = 2.54% Clopidogrel semi-responder = 12.7% Females gender and high triglyceride level were significantly associated |
|
Mandikar H et al. (12) 2007 |
CAD or Stoke/TIA or PAD or multiple atherosclerotic risk factors (n = 130) |
Nagpur, Maharashtra | Aspirin = 150 mg OD | LTA (Aspirin hyporesponder = platelet aggregation value >2SD of mean with 0.5 mM AA) |
Aspirin resistance = 3.1% |
|
Guha S et al. (8) 2009 |
ACS (n = 144) |
Kolkata, West Bengal | Loading: Aspirin-325 mg Clopidogrel-300 mg Maintenance: Aspirin-150 mg Clopidogrel-75 mg |
LTA (NA) |
Aspirin resistance = 15.27% Clopidogrel resistance = 19.44% Dual = 12.5% |
|
Guha S et al. (10) 2009 |
ACS (n = 210) |
Kolkata, West Bengal | Loading: Aspirin-325 mg Clopidogrel-300 mg Maintenance: Aspirin-150 mg Clopidogrel-75 mg |
LTA (Aspirin and Clopidogrel resistance = ≥50% platelet aggregation with collagen and ADP respectively) |
Aspirin resistance = 35% Clopidogrel resistance = 72.5% Dual = 32.5% |
|
Thomson VS et al. (16) 2009 |
Stable CAD (n = 63) |
Vellore, Tamilnadu | Aspirin 75 mg | Urinary 11-Dehydro Thromboxane B2 Aspirin resistance = normalized urinary DTB2 level >67.9 ng/mmol of creatinine |
Aspirin resistance: 38.1% Elevated metabolite level (>320 pg/ml): high risk of vascular events at mean36 months of follow up |
|
Kar R et al. (18) 2012 |
Stable CAD (n = 100) |
Delhi, Delhi | Clopidogrel 75 mg ± aspirin | LTA (Clopidogrel Resistance = <10% decrease from baseline in platelet aggregation with 5 μM ADP Clopidogrel semi-responder= <30% decrease from baseline) |
Clopidogrel non responder: 13% Clopidogrel semi responder: 19% No association with P2Y12 polymorphism |
|
Paul R et al. (9) 2013 |
ACS (n = 94) |
Kolkata, West Bengal | Aspirin = 150 mg OD Clopidogrel = 75 mg OD |
LTA (Aspirin resistance= >50% platelet aggregation with 2 μM/mL collagen Clopidogrel resistance= >50% platelet aggregation with 10 μM ADP |
Aspirin resistance = 22% Clopidogrel resistance = 20.2% Significant association of Metabolic syndrome and serum fibrinogen level with antiplatelet resistance. CRP showed a strong correlation with Aspirin resistance |
|
Koshy SK et al. (20) 2014 |
Stable CAD (n = 100) |
Calicut, Kerala | Aspirin = 75-150 mg Clopidogrel = 75 mg |
Impact R device (Aspirin Resistance = With 0.32 mM AA <2.5% SC (Surface Covered) value. Clopidogrel Resistance = With 1.38 μM ADP <2.8% SC (Surface Covered) value. |
Aspirin resistance: 12% Clopidogrel resistance: 19% Dual: 10% |
|
Priyadarshini R et al. (15) 2014 |
CSA (n = 147) |
Puducherry | Clopidogrel = 75 mg | Impedance aggregometer (Clopidogrel resistance = platelet aggregation < 5Ω with 10 μM ADP by impedance aggregometry) |
Clopidogrel resistance = 33% Significant association with CYP 3A5∗3 polymorphism |
|
Chadha DS et al. (17) 2014 |
Stable CAD (n = 126) |
Pune, Maharashtra | Aspirin = 150 mg | LTA (Aspirin resistance = mean platelet aggregation of ≥70% with 10 μM ADP and a mean aggregation of ≥20% with 0.5 mg/mL AA Aspirin semi-resistance = Any of above criteria) |
Aspirin resistance = 2% Aspirin semi-responders = 34% |
|
Dalal JJ et al. (11) 2015 |
Post PCI (n = 539) |
Mumbai, Maharashtra | Aspirin, Clopidogrel, Ticagrelor, Prasugrel (doses NA) | Thromboelastography (Antiplatelet Resistance = mean platelet inhibition <50%) |
Clopidogrel resistance = 27.85% (Prasugrel resistance = 5.77% Ticagrelor resistance = 0.85%) |
|
Arya V et al. (13) 2015 |
Stable CAD (n = 72) |
Delhi, Delhi | Aspirin 75-150 mg Clopidogrel 75 mg |
LTA (Aspirin resistance = mean platelet aggregation of ≥70% with 10 μM ADP and a mean aggregation of ≥20% with 0.75 mg/mL AA Clopidogrel Resistance = <10% decrease from baseline in platelet aggregation with 10 μM ADP Clopidogrel semi-responder= <30% decrease from baseline) |
Clopidogrel non responder: 1.4% Clopidogrel semi responder: 50% Aspirin semi responder: 5.5% Aspirin resistance = nil Significant association with CYP2C19∗2 polymorphism |