Impact of Body Mass Index on Platelet Aggregation After Administration of a High Loading Dose of 600 mg of Clopidogrel Before Percutaneous Coronary Intervention

doi:10.1016/j.amjcard.2007.02.081

The American Journal of Cardiology

Volume 100, Issue 2, 15 July 2007, Pages 203-205

https://doi.org/10.1016/j.amjcard.2007.02.081 Get rights and content

This study assessed the effect of body mass index (BMI) on platelet aggregation after administration of a high loading dose of clopidogrel 600 mg. Blood samples of 402 patients before percutaneous coronary intervention were collected ≥2 hours after administration of clopidogrel 600 mg. Platelet aggregation was measured in response to adenosine diphosphate (ADP; 5 and 20 μM). Patients were categorized as normal weight (BMI <25 kg/m²) or overweight (BMI ≥25 kg/m²). ADP-induced platelet aggregation was significantly higher in overweight patients than in normal-weight patients (46.0 ± 21.8% vs 38.2 ± 19.3% for ADP 5 μM, p = 0.0007; 55.1 ± 22.7% vs 45.2 ± 21.7% for ADP 20 μM, p <0.0001). Multivariate analyses demonstrated high BMI as the only independent predictor for increased ADP-induced platelet aggregation (p ≤0.005). In conclusion, administration of a single high loading dose of clopidogrel 600 mg does not inhibit platelet aggregation in overweight patients to the same extent as in normal-weight patients.

Section snippets

Methods and Results

Eligible for this study were 402 consecutive patients with coronary artery disease (CAD) before PCI. Blood samples were obtained from the arterial sheath before intervention and ≥2 hours after administration of clopidogrel 600 mg.1, 2, 3 For analyses of data patients were first stratified into quartiles according to BMI and then as overweight (BMI ≥25 kg/m²) or normal weight (BMI <25 kg/m²). This stratification agrees with the definition of overweight patients by the World Health Organization.⁴

Discussion

This is the first study in which parameters of platelet aggregation were assessed in a large population of overweight and normal-weight patients after administration of a single high dose of clopidogrel 600 mg. The main result of this study is that agonist-induced platelet aggregation ≥2 hours after treatment with clopidogrel 600 mg is significantly higher in overweight than in normal-weight patients. Results of the present study are in line with data of Angiolillo et al⁵ showing increased

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En pacientes con SCA, el IMC no influyó significativamente en el efecto del tratamiento con ticagrelor en términos de eficacia o seguridad frente al prasugrel.
The efficacy and safety of ticagrelor vs prasugrel in patients with acute coronary syndromes (ACS) according to body mass index (BMI) remain unstudied. We assessed the efficacy and safety of ticagrelor vs prasugrel in patients with ACS according to BMI.
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Clinicaltrials.gov, no. NCT04078737.

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Coronary artery diseaseImpact of Body Mass Index on Platelet Aggregation After Administration of a High Loading Dose of 600 mg of Clopidogrel Before Percutaneous Coronary Intervention

Section snippets

Methods and Results

Discussion

J Lab Clin Med

J Am Coll Cardiol

J Am Coll Cardiol

J Am Coll Cardiol

Am J Cardiol

J Am Coll Cardiol

Am J Cardiol

Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial

JAMA

Randomized clinical trial of abciximab in diabetic patients undergoing elective percutaneous coronary interventions after treatment with a high loading dose of clopidogrel

Circulation

Coronary artery disease
Impact of Body Mass Index on Platelet Aggregation After Administration of a High Loading Dose of 600 mg of Clopidogrel Before Percutaneous Coronary Intervention