Prevalence of Aspirin and Clopidogrel Resistance in Patients with Recurrent Ischaemic Cerebrovascular Disease

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Objective: This study aimed to identify the prevalence of antiplatelet and clopidogrel resistance in ischaemic cerebrovascular disease patients at Bethesda Hospital, Yogyakarta, Indonesia.

Material and methods: This study was performed using a descriptive method with a cross-sectional study of 260 patients. The inclusion criteria were male or female, age >18 years, have a recurrent ischaemic cerebrovascular disease, and have antiplatelet medication. The data were obtained from the electronic stroke register at Bethesda Hospital.

A point-of-care analyser, Verify Now (Accumetrics), was used to measure the responsiveness of antiplatelet therapy. Aspirin resistance was defined as an aspirin reaction unit (ARU) ≥550. Clopidogrel resistance was defined as P2Y12 PRU ≥230.

Results: Of 260 patients with recurrent ischaemic cerebrovascular disease on antiplatelet therapies, 205 patients were on aspirin therapy, 72 on clopidogrel therapy and on both antiplatelet drugs. Subjects were mainly men and >60 years old. Forty-one of 205 aspirin users (20%) were resistant to aspirin, 24 of 72 (33%) clopidogrel users were resistant to clopidogrel, and 2 of 17 resistant to both antiplatelets.

Conclusion: The prevalence of clopidogrel resistance was higher than aspirin resistance in recurrent ischaemic cerebrovascular disease patients at Bethesda Hospital, Yogyakarta.