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Dr. Nirankar Singh Neki, MBBS, MD(Internal Medicine) is working as Professor and Head of Medicine unit 2 at Govt. Medical College Amritsar, India. He has teaching experience of 30 years as an undergraduate teacher and 28 years as a postgraduate teacher. He has an entry in the Limca Book of Records of 2015 for being the recipient of four Fellowships of the Royal College of Physicians (Edinburgh, Glasgow, Ireland, and London). In total, he has 38 fellowship awards with different institutes. He is the recipient of FACC (USA), FAHA (USA), FESC, FACP(USA), and holds name in cardiology .Dr. Neki holds 13 different Oration Awards and has been a named author in 365 scientific publications, including book chapters. He is also Editor in Chief, Senior Editor, Editor, Section Editor, and Associate Editor of more than 13 national and international medical journals. Dr. Neki has been a Visiting Professor at James Cook University Hospital in Durham, UK and at the University of Manitoba's Institute of Cardiovascular Sciences at St. Boniface Hospital &Research Centre, Winnipeg, Canada.
Antiplatelets are mainly used in the prevention and management of atherothrombotic complications. Current ACC/AHA/ESC guidelines suggest dual antiplatelet therapy (combining aspirin & clopidogrel) for patients having acute coronary syndromes or undergoing PCI. But in spite of administration of dual antiplatelet therapy, some patients develop recurrent cardiovascular ischemic events especially stent thrombosis which is a serious clinical problem. Clopidogrel is an effective inhibitor of platelet activation and aggregation due to selective and irreversible blockade of the P2Y2 receptors. The mechanism of clopidogrel resistance remains incompletely defined but there are certain clinical, cellular and genetic factors including polymorphisms responsible for therapeutic failure. The prevalence of clopidogrel nonresponse varies from 4% to 30% 24 hours after administration. Currently there is no standardized or widely accepted definition of clopidogrel resistance. This presentation is focussed on the methods used to identify patients with clopidogrel resistance, the underlying mechanisms, metabolism, clinical significance and current therapeutic strategies to overcome clopidogrel resistance.