Clopidogrel resistance after renal transplantation

In Vivo. 2015 Mar-Apr;29(2):301-3.

Abstract

Background: Leading causes of mortality and morbidity after kidney transplantation are cardiovascular diseases. One of the fundamentals of their prevention is the inhibition of platelet aggregation. Resistance to anti-platelet agents is a well-established phenomenon; however, its causes are yet to be clarified.

Patients and methods: Forty post-transplant patients, who received 75 mg clopidogrel q.d. as a prophylactic measure, were examined using optical aggregometry. Subsequently, logistic regression analysis was performed with 24 variables in order to expose possible causes of resistance.

Results: Sixty percent of patients (24) were resistant to clopidogrel therapy; effective thrombocyte inhibition could only be shown in 40% of them (16). Significant correspondence between resistance and variables could not be found.

Conclusion: Clopidogrel resistance is expected to occur on a large scale in patients who underwent kidney transplant surgery. Thus, a key component of preventive therapy, which stresses the importance of discovering the cause of resistance so as to decrease mortality rates, is missing.

Keywords: Cardiovascular complication; clopidogrel resistance; platelet aggregation; transplantation.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Clopidogrel
  • Drug Resistance*
  • Female
  • Humans
  • Kidney Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Platelet Aggregation / drug effects
  • Platelet Aggregation Inhibitors / pharmacology
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / pharmacology
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine