Abstract

TRIPLE ANTIPLATELET THERAPY AND INCIDANCE OF DRUG RESISTANCE

Purva B. Patel*, Dr. I.S. Anand and Dr. Kamal Sharma

Abstract

Background: Evidence from small clinical studies suggests that decreased response, or ‘resistance’, to antiplatelet drugs is associated with subsequent major adverse clinical events. Platelet resistance is reflected as major adverse clinical events. On the basis of that we assessed the safety parameters for triple antiplatelet therapy in comparison of dual antiplatelet therapy. Methods: The patients who had undergone PTCA (n=120) were treated with triple (aspirin, clopidogrel and cilostazol) antiplatelet therapy or standard dual (aspirin and clopidogrel) antiplatelet therapy. Clinical safety and adverse outcomes were noted. Results: Results over a treatment period shows that triple antiplatelet therapy group does not increase bleeding risk compare to standard dual antiplatelet therapy group. There were 3 patients with local hematoma, 1 with sub-acute thrombosis, 2 with myocardial infarction and 2 patients with repeat intervention in triple antiplatelet therapy group. Conclusion: Study results show that triple antiplatelet therapy being given to prevent restenosis compared to dual antiplatelet therapy is safe to use in post-PTCA patients in real world patients in India especially in Gujarat with high doses of clopidogrel and aspirin. Because our event rates were similar we can’t conclude triple antiplatelet overcome resistance in this study.

Keywords: triple antiplatelet therapy, cilostazol, resistance.