Patient characteristics associated with a hyper- and hypo-response to clopidogrel therapy in patients undergoing endovascular treatment of unruptured cerebral aneurysms
| Mean initial PRU | Initial hyper-response (PRU <60) (%) | Initial hypo-response (PRU >240) (%) | Any hyper-response (PRU <60)* (%) | |
|---|---|---|---|---|
| All patients (n=100) | 136.5 | 21 (21) | 15 (15) | 45 (45) |
| Sex | ||||
| Female (n=76) | 131.8 | 19 (25) | 11 (14.5) | 37 (48.7) |
| Male (n=24) | 151.4 | 2 (8.3) | 4 (16.7) | 8 (33.3) |
| Age (years) | ||||
| 25–50 (n=29) | 138.9 | 6 (20.7) | 5 (17.2) | 14 (48.3) |
| 51–65 (n=45) | 118.9† | 11 (24.4) | 4 (8.9) | 21 (46.7) |
| 66–82 (n=26) | 164.5† | 4 (15.4) | 6 (23.1) | 10 (38.5) |
| Weight (lb) | ||||
| ≤150 (n=29) | 132.4 | 7 (24.1) | 5 (17.2) | 15 (46.2)‡ |
| 151–200 (n=43) | 115.7† | 12 (27.9) | 6 (14) | 23 (51.2)‡ |
| >200 (n=28) | 172.6† | 2 (7.1) | 4 (14.3) | 7 (23.1)‡ |
| BMI (kg/m2) | ||||
| <25 (n=23) | 148.3 | 5 (21.7) | 6 (26.1)§ | 12 (52.2) |
| 25–30 (n=38) | 122.9 | 9 (23.7) | 5 (13.2)§ | 18 (47.4) |
| >30 (n=39) | 142.8 | 7 (17.9) | 4 (10.3)§ | 15 (38.5) |
| Active smoker | ||||
| Yes (n=33) | 132.7 | 7 (21.2) | 3 (9.1) | 14 (42.4) |
| No (n=67) | 138.4 | 14 (20.9) | 12 (17.9) | 31 (46.3) |
| Hypertension | ||||
| Yes (n=61) | 144.6 | 12 (19.7) | 9 (14.8) | 25 (41) |
| No (n=39) | 123.8 | 9 (23.1) | 6 (15.4) | 20 (51.3) |
| Diabetes | ||||
| Yes (n=8) | 155.9 | 2 (25) | 2 (25)§ | 3 (37.5) |
| No (n=92) | 134.8 | 19 (20.7) | 13 (14.1)§ | 42 (45.7) |
| SSRI | ||||
| Yes (n=17) | 173.9 | 3 (17.6) | 4 (23.5)§ | 8 (47.1) |
| No (n=83) | 128.8 | 18 (21.7) | 11 (13.3)§ | 37 (44.6) |
| PPI | ||||
| Yes (n=22) | 138.5 | 4 (18.2) | 2 (9.1) | 8 (36.4) |
| No (n=78) | 135.9 | 17 (21.8) | 13 (16.7) | 37 (47.4) |
| Statin | ||||
| Yes (n=32) | 128.6 | 8 (25) | 3 (9.4) | 16 (50) |
| No (n=68) | 140.2 | 13 (19.1) | 12 (17.6) | 29 (42.7) |
| Serum creatinine (mg/dL) | ||||
| ≤0.8 (n=52) | 130.6 | 14 (26.9) | 6 (11.5) | 30 (57.7)‡§ |
| ≥0.9 (n=48) | 142.9 | 7 (14.6) | 9 (18.8) | 15 (31.3)‡§ |
| Hemoglobin (g/dL) | ||||
| ≤13.5 (n=50) | 140.7 | 13 (26) | 10 (20)§ | 21 (42) |
| ≥13.6 (n=50) | 132.3 | 8 (16) | 5 (10)§ | 24 (48) |
| Hematocrit | ||||
| ≤40.5 (n=50) | 137.1 | 12 (24) | 9 (18) | 22 (44) |
| ≥40.6 (n=50) | 135.9 | 9 (18) | 6 (12) | 23 (46) |
| Platelets (×103/mL) | ||||
| <200 (n=27 | 162.6† | 3 (11.1) | 7 (25.9)§ | 8 (29.6) |
| 200–300 (n=49) | 136.8 | 9 (18.4) | 6 (12.2)§ | 22 (44.9) |
| >300 (n=24) | 106.6† | 9 (37.5) | 2 (8.3)§ | 15 (62.5) |
*Hyper-response identified at any time during the course of clopidogrel administration.
†Statistically significant difference between the sample means using the t test (p≤0.05).
‡Statistically significant difference in univariate analysis with the χ2 or Fisher's exact test (p≤0.05).
§Independent predictor in multivariate logistic regression analysis (p≤0.05).
BMI, body mass index; PPI, proton pump inhibitor; PRU, P2Y12 reaction units; SSRI, selective serotonin reuptake inhibitor.