Study on Clopidogrel Resistance in Adults Undergoing Carotid Stenting with Dual Antiplatelet Therapy

What this Trial Is About

This research is a prospective observational study conducted at multiple centers to evaluate whether there is a statistical difference in outcomes between patients who do not respond to clopidogrel and receive ticagrelor, and patients who respond to clopidogrel, all undergoing carotid stenting. The study focuses on the rates of death, major adverse cardiovascular events MACE, and major bleeding events at 1 and 3 months post-procedure. It also aims to identify clinical and pharmacological factors linked to resistance to clopidogrel. Participants will undergo carotid stenting and receive dual antiplatelet therapy with aspirin ASA plus clopidogrel initially. Patients showing resistance to clopidogrel through a platelet function test impedance aggregometry will switch therapy to ASA plus ticagrelor. The platelet function is assessed using the Multiplate4 platelet function analyzer, which measures platelet aggregation via electrical impedance in whole blood samples. Blood samples are taken at hospitalization or at least 6 hours after starting clopidogrel. Participants medical records will be reviewed for clinical data, cardiovascular risk factors, carotid plaque characteristics, and medication history. Follow-up includes ultrasound examinations at 1, 6, and 12 months after the procedure and annually afterward. Additional angio-CT scans are done if complications are detected. Data on death, stent thrombosis, cerebrovascular and cardiac events, and major bleeding will be collected. The study will monitor the effectiveness of antiplatelet drugs and their impact on outcomes over time.

Multicentric Study on Clopidogrel Resistance in DAPT for CAS (MULTI-RESCLOSA)