Clopidogrel Resistance Among Ischemic Stroke Patients and Its Risk Factors in Indonesia

Authors

  • Rakhmad Hidayat Faculty of Medicine Universitas Indonesia; Dr. Cipto Mangunkusumo Hospital
  • Rizqi Amanda Nabilah Faculty of Medicine Universitas Indonesia
  • Al Rasyid Faculty of Medicine Universitas Indonesia; Dr. Cipto Mangunkusumo Hospital
  • Salim Harris Faculty of Medicine Universitas Indonesia; Dr. Cipto Mangunkusumo Hospital
  • Alida R. Harahap Faculty of Medicine Universitas Indonesia
  • Herqutanto Herqutanto Faculty of Medicine Universitas Indonesia
  • Melva Louisa Faculty of Medicine Universitas Indonesia
  • Erlin Listyaningsih Harapan Kita Hospital
  • Aldy Safruddin Rambe Sumatera Utara University
  • Tonny Loho Faculty of Medicine and Health Science, Kristen Krida Wacana University

DOI:

https://doi.org/10.5644/ama2006-124.367

Keywords:

Clopidogrel Resistance, Ischemic Stroke, Risk Factors

Abstract

Objective. Clopidogrel is a common antiplatelet used as secondary prevention of ischemic stroke, known to have better efficacy than aspirin, with a equivalent safety profile. However, clopidogrel resistance is not uncommon but has not been widely studied in Asia. This study will further assess clopidogrel resistance and its risk factors.

Materials and Methods. A cross-sectional study was conducted at Rumah Sakit Universitas, Indonesia, and Rumah Sakit Cipto Mangunkusumo, Indonesia in 2020-2021. All patients had had at least one episode of ischemic stroke. Clopidogrel resistance was assessed using a VerifyNow assay.

Results. 57 subjects were enrolled in this study. We found 15.8% of subjects were clopidogrel resistant. Gender was significantly associated with clopidogrel resistance, with males having 80% lower clopidogrel resistance (OR 0.2 (95% CI 0.022 – 0.638); P=0.006). Meanwhile, smoking was not associated with clopidogrel responsiveness (P=0.051). We found no association between haemoglobin, blood glucose, HbA1c, cholesterol, liver enzymes, serum urea concentration or creatinine levels and clopidogrel resistance.

Conclusion. Clopidogrel remains an effective treatment to prevent recurrent ischemic stroke in Indonesia. Further studies are needed to assess gene polymorphism and clopidogrel resistance, which may explain the findings of this study.

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Published

2022-12-16

How to Cite

Hidayat, R., Nabilah, R. A., Rasyid, A., Harris, S., Harahap, A. R., Herqutanto, H., Louisa, M., Listyaningsih, E., Safruddin Rambe, A., & Loho, T. (2022). Clopidogrel Resistance Among Ischemic Stroke Patients and Its Risk Factors in Indonesia. Acta Medica Academica, 51(1), 29–34. https://doi.org/10.5644/ama2006-124.367

Issue

Section

Clinical Medicine

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