TY - JOUR T1 - Prevalence of clOpidogrel ‘resIstaNce’ in a selected population of patients undergoing elective percutaneous coronary intervention at a tertiary cardiovascular centre in Trinidad: the POINT pilot study JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2018-000841 VL - 6 IS - 1 SP - e000841 AU - Naveen Anand Seecheran AU - Aarti Maharaj AU - Brent Boodhai AU - Rajeev Seecheran AU - Valmiki Seecheran AU - Sangeeta Persad AU - Koomatie Ramsaroop AU - Sherry Sandy AU - Stanley Giddings AU - Sateesh Sakhamuri AU - Ronan Ali AU - Shastri Motilal AU - Surujpal Teelucksingh AU - Antonio Tello-Montoliu Y1 - 2019/02/01 UR - http://openheart.bmj.com/content/6/1/e000841.abstract N2 - Objectives  This novel, pilot study aimed to assess the estimated prevalence of high on-treatment platelet reactivity (HPR) in Trinidad and Tobago.Methods Patients (n=40) who were awaiting elective percutaneous coronary intervention on maintenance dual antiplatelet therapy (DAPT) with aspirin 81 mg daily and clopidogrel 75 mg or loaded at least 48 hours prior were recruited. Platelet reactivity with the VerifyNow P2Y12 assay (Accriva Diagnostics, San Diego, California, USA) was assessed prior to cardiac catheterisation.Results 60.7% (17/28) of the South Asian (Indo-Trinidadians) patients had HPR, whereas 14.3% (1/7) of Africans and 40% (2/5) of mixed ethnicity had HPR. There was a significant association between HPR (P2Y12 reaction units >208) and ethnicity with South Asians (Indo-Trinidadians) (OR 5.4; 95% CI 1.18 to 24.66, p=0.029).Conclusions This pilot study serves to introduce the preliminary observation that the estimated prevalence of HPR is considerably higher within the heterogeneous population in Trinidad at 50% as compared with predominantly Caucasian studies. Furthermore, the HPR is significantly higher in South Asians (Indo-Trinidadians) (>60% of patients) which has severe clinical repercussions considering the cardiovascular disease pandemic. Clopidogrel may not be a satisfactory or optimal antiplatelet agent in this subgroup, and therefore, another more potent antiplatelet such as ticagrelor should be used instead. Further large-scale studies are imperative to confirm these findings. (Funded by the University of the West Indies, St. Augustine; POINT ClinicalTrials.gov number, NCT03667066.) ER -