Clinical predictors of dual aspirin and clopidogrel poor responsiveness in stable cardiovascular patients from the ADRIE study

Abstract

Background:-Poor response to both aspirin and clopidogrel (dual poor responsiveness [DPR]) is a major risk factor for recurrent ischemic events. Objectives:-The aim of this study was to identify factors associated with DPR, defined with specific tests, and derive a predictive clinical score. Methods:-We studied 771 consecutive stable cardiovascular patients treated with aspirin (n-=-223), clopidogrel (n-=-111), or both drugs (n-=-437). Aspirin responsiveness was evaluated by serum thromboxane (Tx)B2 assay, and clopidogrel responsiveness by calculating the platelet reactivity index (PRI) on the basis of the phosphorylation status of the vasodilator phosphoprotein. The analysis was focused on patients treated with both drugs, and on independent predictors of DPR. Results:-Among patients on dual therapy, there was no relevant correlation between TxB2 levels and PRI values (r-=-0.11). Sixty-seven patients (15.4%) had DPR. Diabetes [odds ratio (OR) 1.89, 95% confidence interval (CI) 1.06-3.39], high body weight (>-86-kg vs. -1.6-mg-L-1 vs.