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clopidogrel besylate (Plavid)

✓ Approved

HanAll Biopharma · P2RY12 · Small Molecule

What is clopidogrel besylate?

clopidogrel besylate is a small molecule developed by HanAll Biopharma. It is approved for therapeutic indications via unknown.

Drug Profile

Brand NamesPlavid
CompanyHanAll Biopharma
Drug ClassSmall Molecule
Molecular TargetP2RY12
RouteUnknown
StatusApproved
Sources: ClinicalTrials.gov, HanAll Biopharma

Mechanism of Action

Molecular Targets

clopidogrel besylate acts on 1 molecular target:

P2RY12purinergic receptor P2Y12 (P2Y(ADP), P2Y(cyc))
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

clopidogrel besylate is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Vascular disordersThrombosis✓ Approved

Related Research Articles

PubMedUrogynecology (Philadelphia, Pa.)2026-10-15

Chronic Anticoagulation Increases Complications in Obliterative Prolapse Surgery.

Zuo Stephanie W SW, Mumford Brigid S BS, Zyczynski Halina M HM, Ackenbom Mary F MF

Chronic anticoagulation has been identified as a risk factor for postoperative complications in other specialties, but there is a paucity of data on its effect on older women undergoing obliterative prolapse repair. The objective of this study was to assess whether chronic anticoagulation is associated with increased serious adverse events (SAEs) after obliterative prolapse surgery. This was a retrospective cohort analysis of women 65 years or older undergoing obliterative prolapse repair at 2 academic institutions from 2016 to 2023. Patients were identified by Current Procedural Terminology (CPT) code and grouped by preoperative chronic anticoagulation status. The composite primary outcome was defined as SAE within 8 weeks of surgery. Multivariable logistic regression was performed, controlling for relevant variables with P <0.10 on univariate analysis. Among the 777 older women who underwent obliterative surgery, 97 (12.5%) were chronically anticoagulated. The most commonly used anticoagulants were apixaban (n = 37, 38.1%) and clopidogrel (n = 31, 32%), with 21.7% reporting concomitant use of aspirin. Anticoagulated individuals were more likely to be current smokers and to have a history of venous thromboembolism, myocardial infarction, and stroke (P < 0.05). Chronically anticoagulated women had 1.72 times greater adjusted odds of experiencing SAE (95% CI, 1.02-2.91). Chronic anticoagulation was associated with an increased incidence of readmission, cardiac complications, transfusion, hematoma, and organ-space surgical site infection (P < 0.05). Rates of SAEs were highest in individuals taking rivaroxaban (35.7%) and those taking concomitant aspirin (38.1%). Chronic anticoagulation is associated with increased odds of SAE in older women undergoing obliterative prolapse surgery. Physicians should consider this additional risk in surgical decision making and counseling on anticoagulant suspension and resumption perioperatively.

PMID 42878554
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PubMedThe Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques2026-10-14

High Yield of Pharmacogenetic Testing for Clopidogrel Resistance in a Canadian Outpatient Stroke Population.

Rajendram Phavalan P, Boulos Mark M, Dharmakulaseelan Laavanya L, Xie Henry H et al.

Clopidogrel is commonly prescribed for secondary stroke prevention, but routine pharmacogenetic testing is not typically performed. As the CYP2C19 enzyme activates clopidogrel into its effective form, clopidogrel-treated patients who carry CYP2C19 loss-of-function alleles may face an increased risk of recurrent stroke. We examined the prevalence of CYP2C19 loss-of-function variants and their potential influence on patient management within a Canadian stroke clinic population. We randomly selected and invited outpatients attending a regional stroke prevention clinic in Toronto, Canada, who had a non-cardioembolic ischemic stroke or transient ischemic attack and were prescribed clopidogrel for secondary stroke prevention. Participants completed a self-administered home DNA test (cheek swab) to determine their CYP2C19 status. The primary outcome was the prevalence of intermediate or poor metabolizers. The secondary outcome was the proportion of participants whose antiplatelet regimen was changed as a result of the testing. Among 93 eligible participants who underwent the test (mean age 68.1; female 37.6%), 31 (33.3%) were intermediate metabolizers, 8 (8.6%) were poor metabolizers, 20 (21.5%) were rapid metabolizers, 9 (9.7%) were ultrarapid metabolizers and 25 (26.9%) were normal metabolizers. In 8 (100.0%) of the poor metabolizers and 20 (64.5%) of the intermediate metabolizers, treating physicians changed their antiplatelet prescriptions based on the test results. In this cohort of post-stroke patients treated with clopidogrel, genetic testing showed a high prevalence (41.9%) of intermediate or poor clopidogrel metabolizers, resulting in a change in antiplatelet therapy prescriptions in over 70% of those cases. These findings have implications for secondary stroke prevention.

PMID 42870560
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PubMedFrontiers in stroke2026-10-13

A prospective study evaluating clopidogrel resistance among patients with ischemic cerebrovascular events across different ethnic groups in Israel.

Shbat Fadi F, Beiruti Wiegler Karine K, Dally Najib N, Saad Elias E et al.

Clopidogrel is commonly used for secondary prevention after ischemic cerebrovascular events, but substantial interindividual variability in pharmacodynamics response has been reported. Individuals demonstrating resistance to clopidogrel face a higher likelihood of recurrent ischemic events. This study evaluated clopidogrel responsiveness among Jewish and Arab patients treated within the same regional healthcare setting. This prospective cohort included 102 patients with ischemic cerebrovascular events (acute ischemic stroke or transient ischemic attack) receiving clopidogrel for secondary prevention. Patients received either a loading dose (300 in 62 patients, 600 mg in 1 patient) followed by maintenance therapy or at least 7 days of 75 mg daily maintenance dosing (n = 39) prior to blood sampling. Platelet responsiveness was measured using the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay (PLT VASP/P2Y12, BioCytex, France). Patients were categorized according to VASP platelet reactivity index (PRI) as adequate responders (PRI <50%), intermediate responders (PRI 50%-69%), or patients with high residual platelet reactivity, operationally defined in this study as PRI ≥70%. The study included 102 enrolled patients, of whom 57 (55.9%) were Jewish and 45 (44.1%) were Arab. A valid VASP-PRI measurement was available for 101 patients (57 Jewish and 44 Arab); one Arab patient had no evaluable PRI measurement. Therefore, analyses of platelet reactivity were based on 101 patients The median PRI for all patients was 65.5 (49.1-80.3), with no statistically significant differences between Jewish and Arab (p = 0.251). Overall, 42.6% were classified as non-responders, 29.7% as partial responders, and only 27.7% demonstrated adequate platelet inhibition. Jewish patients were significantly older than Arab patients (p = 0.008), whereas Arab patients had a significantly higher BMI (p = 0.019). Other demographic and clinical features were similar across groups. A high proportion of patients demonstrated elevated residual platelet reactivity according to the operational PRI threshold used in this study. No statistically significant ethnic difference in PRI was detected; however, the ethnic comparison was exploratory and the study was not powered to exclude modest between-group differences. Larger prospective studies incorporating CYP2C19 genotyping and longitudinal clinical outcomes are warranted.

PMID 42865374
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PubMedJournal of thoracic disease2026-10-13

Preoperative antiplatelet strategies and coronary artery bypass graft outcomes: bleeding and cardiovascular events in 41,696 patients with acute coronary syndrome.

Liu Rui R, Zhang Ze Z, An Lili L, Tian Meice M et al.

The aim of this study wasto evaluate the clinical effects of preoperative antiplatelet therapy (APT) discontinuation timing on major bleeding and adverse cardiac events in patients undergoing coronary artery bypass grafting (CABG). This retrospective cohort study analyzed data from Fuwai Cardiac Surgery Database (FCSD), specifically from 41,689 patients with acute coronary syndrome undergoing isolated CABG (2009-2019). A comparison was conducted between 10,739 patients treated with continuation APT (AP group; discontinued ≤7 days preoperation; including aspirin alone, clopidogrel alone, or aspirin + clopidogrel) and 30,950 patients with discontinuation therapy (NAP group; >7 days preoperation). Major bleeding events were defined according to the Bleeding Academic Research Consortium-CABG criteria. Composite adverse events (30-day all-cause mortality, stroke, myocardial infarction, and acute renal failure) were assessed. Multivariable logistic regression was applied to estimate effects. Adverse cardiac events occurred in 7.8% of patients in the AP group and 9.1% in the NAP group (P<0.001), but there was no difference in the incidence of major bleeding events. Multivariable analysis showed that continuation therapy significantly decreased the risk of adverse cardiac events [odds ratio (OR) 0.832; 95% confidence interval (CI): 0.754-0.918; P<0.001] without increasing the risk of major bleeding events (OR 1.006; 95% CI: 0.926-1.093; P=0.88). Subgroup analysis identified certain strategies for reducing adverse events without bleeding. Preoperative continued APT significantly reduces the risk of 30-day adverse cardiac events post-CABG without increasing the risk of major bleeding. Optimal strategies include clopidogrel alone (discontinued <3 days preoperatively) and dual-antiplatelet therapy (aspirin + clopidogrel discontinued 5-7 days preoperatively).

PMID 42865851
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PubMedCJC open2026-10-12

Antiplatelet Therapy Strategies in Patients with High Bleeding Risk Treated with Complex Percutaneous Coronary Intervention: A Descriptive Study.

Ravet-Claret Éloi É, Chen Susan S, Goulet Adèle A, Tcaciuc Dan D et al.

Following acute coronary syndrome (ACS) treated by percutaneous coronary intervention (PCI), guideline-directed dual antiplatelet therapy (DAPT) typically consists of 12 months of aspirin plus a P2Y12 inhibitor. Recent trials support antiplatelet de-escalation strategies in patients at high bleeding risk (HBR), whereas patients undergoing complex PCI are at increased thrombotic risk and may benefit from extended DAPT. The overlap between these groups with high bleeding risk and high thrombotic risk in contemporary practice is not well characterized. Patients undergoing PCI for ACS were randomly sampled from those hospitalized at the Montreal Heart Institute between May 1, 2024 and April 30, 2025. Data were extracted from electronic health records. HBR was assessed using the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy-High Bleeding Risk (PRECISE-HBR) score, and complex PCI was assessed using guideline-based criteria. The primary objective was to estimate the proportion of patients meeting both criteria; secondary objectives described discharge antiplatelet strategies across risk groups. Of the 309 participants sampled, 35% were identified as being at HBR, 43% underwent complex PCI, and 17.5% (95% confidence interval, 13.3%-21.7%) met both HBR and complex PCI criteria. De-escalation strategies were infrequently prescribed across risk groups, even among patients at HBR without complex PCI. Among those not receiving long-term anticoagulation, only 4.2% received a de-escalation strategy. Nearly 1 in 6 patients undergoing PCI for ACS met both HBR and complex PCI criteria. In this setting, clinicians appeared to favour standard-duration clopidogrel-based DAPT rather than de-escalation approaches. These findings underscore the need for practical guidance to support individualized antiplatelet decision-making in patients with competing bleeding and ischemic risks.

PMID 42861329
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PubMedCirculation. Cardiovascular interventions2026-10-12

High-Potency P2Y12 Inhibitors Among Patients With Chronic Coronary Syndrome Undergoing PCI: An Analysis From the NCDR CathPCI Registry.

Fath Ayman R AR, Rymer Jennifer J, Marks Angel A, Wojdyla Daniel D et al.

Clinical practice guidelines recommend the use of clopidogrel among patients with chronic coronary syndrome undergoing percutaneous coronary intervention. The frequency of high-potency P2Y12 inhibitors, such as ticagrelor or prasugrel, in this setting is not well known. Using the National Cardiovascular Data Registry CathPCI registry, we analyzed patients with chronic coronary syndrome undergoing percutaneous coronary intervention from April 2018 to June 2024, excluding those discharged on oral anticoagulants. Temporal trends in high-potency P2Y12 inhibitor prescription were examined. A mixed-effects multivariable logistic regression model with a random intercept for hospital was used to identify patient-, procedural-, and institutional-level factors associated with high-potency P2Y12 inhibitor prescription while accounting for within-hospital clustering. Between-hospital variation was quantified using the median odds ratio. Among 783 977 patients across 1815 hospitals, 35% were prescribed a high-potency P2Y12 inhibitor at discharge. The use of high-potency P2Y12 inhibitors declined from 35% in 2018 to 31% in 2024 (P-trend=0.019), driven by a reduction in ticagrelor (from 29% to 23%, P-trend <0.001) despite a modest increase in prasugrel use (from 6.2% to 8%, P-trend=0.10). Male sex, prior myocardial infarction, and markers of procedural complexity (high-complexity/type C lesions, left main coronary artery, proximal left anterior descending artery, or use of mechanical circulatory support) were associated with higher odds of high-potency P2Y12 inhibitor prescription. In contrast, older age (≥75 years), prior stroke/transient ischemic attack, prior coronary artery bypass graft, severe renal dysfunction, and chronic total occlusion were associated with lower odds. University hospitals had lower odds of prescribing high-potency P2Y12 inhibitors, with considerable variability in prescription patterns among institutions (median odds ratio, 2.59). Nearly one-third of chronic coronary syndrome patients undergoing percutaneous coronary intervention were discharged on high-potency P2Y12 inhibitors, with decreasing trends over time. Practice patterns reflected perceived ischemic versus bleeding risk and significant institutional variation, underscoring opportunities for quality improvement and guideline alignment.

PMID 42861503
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