Tesis

Proporsi dan Faktor yang Mempengaruhi Resistensi Klopidogrel pada Pasien Sindrom Koroner Akut dan/atau Post Intervensi Koroner Perkutan di RS Jantung dan Pembuluh Darah Harapan Kita = The proportion and factors affecting clopidogrel resistance in patients with acute coronary syndrome and /or post percutaneous coronary intervention at Harapan Kita National Cardiovascular Center.

Klopidogrel merupakan salah satu terapi standar pada pasien SKA dan/atau pasien post IKP. Penggunaan klopidogrel di Indonesia sangat tinggi, namun diduga berbagai faktor dapat menyebabkan variasi hambatan agregasi trombosit yang mengakibatkan resistensi klopidogrel. Sebanyak 100 pasien SKA dan/atau post IKP diperiksa agregasi trombosit dengan metode LTA menggunakan ADP 20µM dan diambil data demografi, klinis, terapi, serta data polimorfisme genetik CYP2C19*2 dan *3. Resisten klopidogrel ditetapkan sebagai persen agregasi trombosit >59%. Proporsi resistensi klopidogrel sebanyak 36(36%). Faktor yang berperan terhadap resistensi klopidogrel adalah tidak merokok, DM, CYP2C19*2 dan *3 dengan prediktor paling dominan adalah polimorfisme CYP2C19*2.
Kata kunci : klopidogrel, resistensi, agregasi, trombosit, CYP2C19


Clopidogrel has become the standard therapy in patients with ACS and/or post PCI. The use of clopidogrel in Indonesia is very high, but expected many factors can cause variability inhibition of platelet aggregation resulting clopidogrel resistance. Total of 100 patients with ACS and /or post PCI were measured with platelet aggregation by LTA method using 20μM ADP and retrieved data of demographic, clinical, therapeutic, and the data on genetic polymorphism CYP2C19 *2 and *3. Clopidogrel resistance was defined as percent platelet aggregation >59%. The proportion of clopidogrel resistant were 36(36%). Factors that contribute to clopidogrel resistance are non smoking status, diabetes, CYP2C19 *2 and *3 with the most dominant predictor is polymorphism CYP2C19 *2.
Keywords : clopidogrel, resistance, aggregation, platelet, CYP2C19