No Rebound Seen in Platelet Aggregation After Clopidogrel

Study finds no advantage to tapering off drug versus abrupt cessation at end of treatment
By Jeff Muise
HealthDay Reporter

THURSDAY, Feb. 4 (HealthDay News) -- There was no rebound in platelet aggregation (PA) observed in cardiovascular patients who stopped taking clopidogrel abruptly or tapered off the medication gradually after the prescribed course of treatment, according to a study in the Feb. 9 issue of the Journal of the American College of Cardiology.

Dirk Sibbing, M.D., of the Technische Universität München in Munich, Germany, and colleagues recruited 69 patients who were receiving clopidogrel treatment following drug-eluting stent placement and were slated to stop the medication. The patients were randomized to either discontinue the clopidogrel gradually in accordance with a predefined four-week tapering regimen or continue taking clopidogrel daily for the four weeks and then stop abruptly. The researchers assessed PA through light transmission aggregometry (LTA) and multiple electrode aggregometry (MEA) at baseline and weekly from week two to eight following randomization. Study end point was the highest value of adenosine diphosphate (ADP)-induced PA following clopidogrel cessation in both groups.

The researchers found that the highest values for APD-induced PA after stopping clopidogrel were similar for both groups as assessed by LTA and MEA, and no evidence was exhibited for either rebound effect or a benefit to tapering off clopidogrel treatment.

"Tapering of clopidogrel does not result in lower PA values after clopidogrel withdrawal. The course of PA values after clopidogrel cessation provides no evidence for the existence of a rebound phenomenon of platelets," the authors write.

Several study authors reported receiving speaker fees or serving on advisory boards for various pharmaceutical companies.

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