ReviewCardiovascular diagnosis and therapy2013
High residual platelet reactivity on clopidogrel: its significance and therapeutic challenges overcoming clopidogrel resistance.
Review in Cardiovascular diagnosis and therapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Role of genetic polymorphisms in clopidogrel response variability: a systematic review.Open heart · 2023Pooled it
- Trial
- Genetic Polymorphism of CYP2C19 and Inhibitory Effects of Ticagrelor and Clopidogrel Towards Post-Percutaneous Coronary Intervention (PCI) Platelet Aggregation in Patients with Acute Coronary Syndromes.Medical science monitor : international medical journal of experimental and clinical research · 2016Trial
- The association of ABCB1, CYP2C19 and CYP2C9 combined activity with clopidogrel resistance in patients with recurrent ischemic stroke.The pharmacogenomics journal · 2026Article
- Association of a platelet function testing-guided intensified antiplatelet strategy with thromboembolic events after EP2 stent-assisted coil embolization in patients with unruptured intracranial aneurysms.Frontiers in neurology · 2026Article
- Advances in the Clinical Use of Clopidogrel: A Review of Individualized Treatment Strategies and Monitoring Optimization Based on Genetic Polymorphisms.Pharmacogenomics and personalized medicine · 2025Review
- Predictive Value of the COP-INH Score for Adverse Cardiovascular Events After PCI in ACS Patients.International journal of general medicine · 2025Article
- Paraoxonase-1 as a Cardiovascular Biomarker in Caribbean Hispanic Patients Treated with Clopidogrel: Abundance and Functionality.International journal of molecular sciences · 2024Article
- High platelet reactivity strongly predicts early stent thrombosis in patients with drug-eluting stent implantation.Scientific reports · 2024Article
- Dual Antiplatelet Therapy: A Concise Review for Clinicians.Life (Basel, Switzerland) · 2023Review
- The Role of Global and Local Ancestry on Clopidogrel Response in African Americans.Pacific Symposium on Biocomputing. Pacific Symposium on Biocomputing · 2023Article
- Does individualized guided selection of antiplatelet therapy improve outcomes after percutaneous coronary intervention? A systematic review and meta-analysis.Annals of medicine and surgery (2012) · 2022Review
- Artificial-Intelligence-Assisted Discovery of Genetic Factors for Precision Medicine of Antiplatelet Therapy in Diabetic Peripheral Artery Disease.Biomedicines · 2022Article
- Reduced number of cardiovascular events and increased cost-effectiveness by genotype-guided antiplatelet therapy in patients undergoing percutaneous coronary interventions in the Netherlands.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2016Article
- Association of Cytochrome P450 Genetic Variants with Clopidogrel Resistance and Outcomes in Acute Ischemic Stroke.Journal of atherosclerosis and thrombosis · 2016Article
- The impact of P2Y12 promoter DNA methylation on the recurrence of ischemic events in Chinese patients with ischemic cerebrovascular disease.Scientific reports · 2016Article
- Pyrroloquinoline quinone protects mouse brain endothelial cells from high glucose-induced damage in vitro.Acta pharmacologica Sinica · 2014Article
- Article
- Early detection of resistance to dual antiplatelet therapy in patients who have undergone percutaneous coronary intervention using the VerifyNow test and associated factors.Medicine internationalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Over the last decade, dual antiplatelet therapy has been the mainstay of the management of Acute Coronary Syndrome, with clopidogrel therapy providing clear benefits over aspirin monotherapy and becoming the agent of choice for the prevention of stent thrombosis. While newer antiplatelet agents have now become available, clopidogrel is still widely used due to its low cost and efficacy. However, many patients still experience recurrent ischemic events. A poor response of the platelets to clopidogrel, called High Residual Platelet Reactivity (HRPR), has been incriminated to account for this dilemma. Despite the absence of a universal definition of HRPR or the gold standard test to quantify it, persistent high platelet reactivity has consistently been associated with recurrence of ischemic events. Clopidogrel metabolism is highly variable, and genetics, comorbidities and drug interactions can affect it. In this article we review all definitions of HRPR, explore the available tests to quantify it, the clinical outcomes associated with it, as well as strategies that have shown success in overcoming it.
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