Cardiologie clinique et expérimentale
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Characterization and Evaluation of Clopidogrel Response Testing in a Community Hospital Setting

Jeffrey Lalama

Purpose: To describe how VerifyNow P2Y12 testing for clopidogrel response is being utilized at a community hospital. Methods: A retrospective chart review was conducted at a 411-bed community hospital in patients who tested positive for poor clopidogrel response.

Results: There were 95 positive P2Y12 tests evaluated in this study. Positive P2Y12 tests were obtained 40.0% of the time for cardiovascular indications, 28.4% for neurologic indications, 1.1% for hematologic indications, and 30.5% were obtained to evaluate patients prior to surgery. The medication regimens of 38.8% of patients did not change as a result of a positive test for poor clopidogrel response. The clopidogrel dose was increased in 16.3% of patients, and clopidogrel was discontinued in 10.2% of patients positive for poor clopidogrel response not undergoing surgical evaluation. Rehospitalization rates of non-surgical patients for recurrent thrombosis or bleeding at 90 days were highest for patients who had an additional antiplatelet agent or anticoagulant added due to poor clopidogrel response. The lowest rehospitalization rate was seen in patients switched to an alternative agent.

Conclusions: The most common findings after a positive P2Y12 test in non-surgical patients were no change in therapy and increasing the dose of clopidogrel. Adding an additional antiplatelet agent or anticoagulant was associated with the highest risk of rehospitalization.