New JACC Study First to Investigate High On-Clopidogrel Outcomes in Bivalirudin Vs. Abciximab Treated N-STEMI Patients
In a study published June 6 in the Journal of the American College of Cardiology (JACC), authors found the impact of high on-clopidogrel treatment platelet reactivity (HPR) on clinical outcomes may depend on the type of adjunct antithrombotic therapy used during percutaneous coronary intervention (PCI).
Several studies have shown that responsiveness to clopidogrel treatment is not uniform and a high on-clopidogrel treatment platelet reactivity (HPR) has been linked to an increased risk for ischemic events. According to study authors, these new data show that for patients with similar risk profiles to those in the study, the effect of HPR on clinical outcomes may depend on the type of adjunctive antithrombotic therapy used during PCI. "Whereas the presence of HPR in bivalirudin treated patients was relevant and predictive for the occurrence of early ischemic events, presence of HPR in abciximab with UFH treated patients had little relevance in this regard. Present data suggest that stronger platelet inhibition, such as provided by abciximab, is beneficial in NSTEMI patients who still have HPR after 600 mg clopidogrel loading," they note.
Moving forward, the study authors suggest that additional research is needed to clarify whether assessment of platelet function may help tailoring antithrombotic therapy during PCI.
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