{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T03:27:21Z","timestamp":1764732441031},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,4,27]],"date-time":"2011-04-27T00:00:00Z","timestamp":1303862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>Despite dual antiplatelet therapy, the rate of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) remains high. Ex vivo tests of clopidogrel resistance can predict MACE after PCI. The purpose of this study is to evaluate the clinical impact of adjusting phosphorylation analysis in patients with clopidogrel resistance undergoing PCI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis:<\/jats:title><jats:p>We hypothesized that VASP\u2010guided clopidogrel maintenance doses, compared to fixed doses, improved clinical outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>This monocentric, prospective, randomized study was performed on 306 patients undergoing PCI. Patients were randomized to a control group (n = 156) and to a vasodilator\u2010stimulated phosphoprotein (VASP)\u2010guided group (n = 150). In the VASP\u2010guided group, patients received adjusted maintenance doses of clopidogrel to obtain platelet reactivity index (PRI) of &lt;50% during 1 year after PCI. The primary endpoint was the rate of MACE. The secondary endpoints were major and minor bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>All patients completed the PCI procedure and 298 patients completed follow\u2010up. The control and VASP\u2010guided groups had similar demographic, clinical, and angiographic characteristics. In the VASP\u2010guided group, PRI was significantly decreased (from 72.1% \u00b1 11.4% to 27.7% \u00b1 8.4%; <jats:italic>P<\/jats:italic> = 0.001) in 128 patients (87.1% of all participants). During the 1\u2010year follow\u2010up, 14 MACEs were recorded in the VASP\u2010guided group and 30 MACEs were recorded in the control group (9.3% vs 20.4%, respectively; <jats:italic>P<\/jats:italic> = 0.008). There was no difference in the rate of major and minor bleeding in the VASP\u2010guided group compared with the control group (12.9% vs 16.6%; <jats:italic>P<\/jats:italic> = 0.06).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Modifying clopidogrel maintenance doses according to platelet reactivity monitoring decreases the rate of MACE after PCI without increasing bleeding in patients with clopidogrel resistance during 1\u2010year follow\u2010up. \u00a9 2011 Wiley Periodicals, Inc.<\/jats:p><jats:p>This project was sponsored by Science and Technology Commission of Shanghai Municipality (No. SK08\u20106). The authors have no other funding, financial relationships, or conflicts of interest to disclose.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.20884","type":"journal-article","created":{"date-parts":[[2011,4,27]],"date-time":"2011-04-27T19:05:39Z","timestamp":1303931139000},"page":"332-338","source":"Crossref","is-referenced-by-count":49,"title":["Modifying Clopidogrel Maintenance Doses According to Vasodilator\u2010Stimulated Phosphoprotein Phosphorylation Index Improves Clinical Outcome in Patients With Clopidogrel 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