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Master Thesis

Prévalence de la résistance au Clopidogrel dans une population de patients âgés de plus de 75 ans hospitalisés en médecine gériatrique

Abstract : Introduction : Clopidogrel is mainly prescribed in Geriatrics for the prevention of a new episode of ischemic stroke or myocardial infarction. Clopidogrel resistance rate is estimated between 16% and 50% in adult population. Data of clopidogrel resistance in older population are scarce. We hypothesized that the prevalence of clopidogrel resistance would be higher in the older population, as resistance associated factors are frequent in this population (diabetes, polypharmacy, etc.). Method: patients aged 75 and over hospitalized in geriatric medicine treated with clopidogrel were prospectively included between 2015 and 2019. A blood test was carried out after 5 days of hospitalization (in order to ensure compliance), including a measurement of platelet activity (Multiplate® and VerifyNow®), a blood count, serum creatinine, reactive C protein, glycosylated hemoglobin and albumin. Concomitant treatments were collected. Results: 59 patients were enrolled (mean ± SD age 84.1 years ± 4.8; Charlson score 6.8 ± 2.1; ADL before admission to hospital 3.8 ± 3.6). The prevalence of clopidogrel resistance was 40.4%. No clinical (Sex, diabetes mellitus, high blood pressure, chronic renal failure, atrial fibrillation, body mass index), biological (glycosylated hemoglobin, creatinine, platelets, platelet volume, hemoglobin, hematocrit, reactive C protein, albumin) or concomitant drug (aspirin, proton pump inhibitors, angiotensin II receptor antagonists, preventive anticoagulation, curative anticoagulation) data studied was associated with an increased risk of resistance to clopidogrel. Conclusion: the prevalence of clopidogrel resistance in a geriatric dependent population with multimorbidities was estimated at 41%. This study did not allow determining factors associated with clopidogrel resistance. In theory this resistance may be linked to recurrence of ischemic stroke or myocardial infarction and futile drug-drug interaction.
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Master Thesis
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Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Thursday, October 22, 2020 - 4:32:51 PM
Last modification on : Saturday, November 7, 2020 - 3:12:30 AM
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Lilian Pedemanaud-Lafon. Prévalence de la résistance au Clopidogrel dans une population de patients âgés de plus de 75 ans hospitalisés en médecine gériatrique. Médecine humaine et pathologie. 2020. ⟨dumas-02975431⟩



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