Journal Article

P065/123  The change of clopidogrel effect after stent-assisted coil embolization despite an acceptable range of response before procedure

O-Ki, Kwon, Ban, Seung Pil, Kim, Young Deok

2023

Overview

IntroductionIt is generally believed that antiplatelet effect, especially clopidogrel, reaches and maintain a therapeutic range and plateau within 5–7 days. However, the consistence of clopidogrel effect after stent-assisted coil embolization is unclear.Aim of StudyThe purpose of this study was to evaluate follow-up P2Y12 reaction unit (PRU) in the patients who underwent stent-assisted coil embolization.MethodsThe Patients were administered a dual antiplatelet (100mg of aspirin and 75mg of clopidogrel) for 5 days prior to coil embolization. The follow-up PRU was evaluated between 2 and 4 weeks after stent-assisted coil embolization in the outpatient clinic. To evaluate the predictability of significant variables for a follow-up PRU value less than 80, the receiver-operating characteristic (ROC) curve method was employed. The optimal cutoff value was determined using the Youden index.ResultsA total of 124 patients with 131 aneurysms were included in this study. The median PRU before coil embolization was 155 (IQR 124–181), and the median follow-up PRU after coil embolization was 142 (IQR 92–179). A total of 29 patients (23.4%) had a follow-up PRU value less than 80. The optimal cut-off value of pre-procedural PRU to predict a follow-up PRU value less than 80 was 124.ConclusionThe PRU level after stent-assisted coil embolization can decrease to a hyper-response level despite an acceptable range of the PRU Before Procedure. The significant predictor of hyper-response was the pre-procedural PRU level. The optimal cut-off value of pre-procedural PRU to predict a follow-up PRU value less than 80 was 124.Disclosure of InterestNothing to disclose

• Publisher: BMJ Publishing Group LTD
• Subject: Embolization