Volume 124, Issue 2, Pages (June 2009)

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Volume 124, Issue 2, Pages 193-198 (June 2009) Antiplatelet effect of clopidogrel in patients with aspirin therapy undergoing percutaneous coronary interventions – Limited inhibition of the P2Y12 receptor Aino Lepäntalo, Kari S. Virtanen, Julio C. Reséndiz, Jussi Mikkelsson, Leena E. Viiri, Pekka J. Karhunen, Riitta Lassila Thrombosis Research Volume 124, Issue 2, Pages 193-198 (June 2009) DOI: 10.1016/j.thromres.2009.01.009 Copyright © 2009 Elsevier Ltd Terms and Conditions

Fig. 1 Distribution of the gained inhibition of ADP (5 µmol/L)-induced platelet aggregation by clopidogrel among 51 CAD patients. Thrombosis Research 2009 124, 193-198DOI: (10.1016/j.thromres.2009.01.009) Copyright © 2009 Elsevier Ltd Terms and Conditions

Fig. 2 ADP (5 µmol/L)-induced aggregation in the presence of ARMX (0, 25, 50, 75 and 100 nmol/L) before (dark bars) and after (grey bars) clopidogrel medication. a) Clopidogrel responders (N=41) and b) non-responders (N=10). Means and 95% confidence intervals are presented. ⁎=P<0.05, ns. = not significant. Thrombosis Research 2009 124, 193-198DOI: (10.1016/j.thromres.2009.01.009) Copyright © 2009 Elsevier Ltd Terms and Conditions

Fig. 3 Inhibition of ADP-induced aggregation by ARMX, A3P5P and their combination before and after clopidogrel treatment. Platelet aggregation was induced with 5 µmol/L ADP. Platelet activation was inhibited by ARMX (AR-C69931MX, 100 nmol/L), A3P5P (adenosine 3,5 diphosphate, 200 µmol/L) and the combination of ARMX and A3P5P. Dark bars indicate the in vitro inhibition of platelet aggregation. The grey bars indicate combined inhibition of in vitro agents and in vivo clopidogrel. Results are given in means and 95% confidence intervals. On top of clopidogrel treatment ADP-induced platelet aggregation can be further inhibited by in vitro P2Y12- and P2Y1- receptor antagonists. ⁎=P<0.05, ns. = not significant. Thrombosis Research 2009 124, 193-198DOI: (10.1016/j.thromres.2009.01.009) Copyright © 2009 Elsevier Ltd Terms and Conditions

Fig. 4 Correlation between inhibition of ADP (5 µmol/L)-induced aggregation by clopidogrel and ARMX 100 nmol/L (r=0.43, P=0.002). Clopidogrel non-responders (N=10) are below the dashed line. Thrombosis Research 2009 124, 193-198DOI: (10.1016/j.thromres.2009.01.009) Copyright © 2009 Elsevier Ltd Terms and Conditions