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뇌졸중 환자에게 아스피린과 클로피도그렐 내성

Aspirin and Clopidogrel Resistance in Stroke Patients

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초록

Background: An increasing number of anti-platelet agents of various action mechanisms has been tested and used to prevent recurrent ischemic events in patients with ischemic stroke. However, the preventive effects of these anti-platelet agents were still limited. Recently, impaired responses to anti-platelet therapy assessed by laboratory tests have been reported to be associated with an increased risk of recurrent ischemic events after stroke or cardiovascular events. Contents: In this review, 1) the mecha-nisms of anti-platelet failure and anti-platelet resistance, 2) laboratory methods to detect anti-platelet resistance, 3) prevalence and clinical implication of it, and 4) possible management for this situation will be discussed. Conclusion: Although there have been increasing evidences of impact of anti-platelet resistance on the recurrent clinical events, at present there was no solid criteria for anti-platelet resistance or definite evidence to recommend a change anti-platelet medication according to the laboratory results in clinical practice. Hopefully, the further studies on anti-platelet resistance may guide the pharmacologic treatment for stroke prevention in patients with ischemic stroke. (Korean J Stroke 2009;11:1-9)

Abstract

Background: An increasing number of anti-platelet agents of various action mechanisms has been tested and used to prevent recurrent ischemic events in patients with ischemic stroke. However, the preventive effects of these anti-platelet agents were still limited. Recently, impaired responses to anti-platelet therapy assessed by laboratory tests have been reported to be associated with an increased risk of recurrent ischemic events after stroke or cardiovascular events. Contents: In this review, 1) the mecha-nisms of anti-platelet failure and anti-platelet resistance, 2) laboratory methods to detect anti-platelet resistance, 3) prevalence and clinical implication of it, and 4) possible management for this situation will be discussed. Conclusion: Although there have been increasing evidences of impact of anti-platelet resistance on the recurrent clinical events, at present there was no solid criteria for anti-platelet resistance or definite evidence to recommend a change anti-platelet medication according to the laboratory results in clinical practice. Hopefully, the further studies on anti-platelet resistance may guide the pharmacologic treatment for stroke prevention in patients with ischemic stroke. (Korean J Stroke 2009;11:1-9)

참고문헌 (52)

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