Enhanced clopidogrel response in smokers is reversed after discontinuation as assessed by VerifyNow assay: additional evidence for the concept of smokers paradox
Park KW et al. – Enhanced clopidogrel response in smokers is reversed after smoking discontinuation, suggesting a causal relationship in addition to the previously reported association between smoking and enhanced clopidogrel response.
From the prospective CROSS–VERIFY cohort, 810 subjects with repeated measurement of OPR at least 1 month apart were analysed.
With smoking status ascertained at two time points, baseline and follow–up, study subjects were categorised into never smokers (n=628), smoking quitters (n=77) and persistent smokers (n=105).
Dependent variables included OPR measured by the VerifyNow assay and the percentage of subjects with high OPR (HOPR).
At baseline, current smokers showed significantly lower OPR compared with never smokers, with no significant differences in OPR between future quitters and future persistent smokers within current smokers.
While the OPR of never smokers and persistent smokers did not change significantly during the follow–up, the mean OPR of quitters increased significantly by 19 P2Y12 reaction units (p=0.013).
The frequency of HOPR showed similar results, with an 8–10% increase in smoking quitters in contrast to no significant changes in never and persistent smokers.
Both mean OPR and the frequency of HOPR showed a linear inverse relationship with the amount of smoking.
MDLinx connects healthcare professionals and patients to tomorrow's important medical news, while providing the pharmaceutical and healthcare industries with highly targeted interactive marketing, education, content, and medical research solutions.