What PRU threshold defines HTPR on clopidogrel?

HTPR defined as VerifyNow P2Y12 >208 PRU (platelet reactivity units). Associated with 2–5× increased risk of MACE post-PCI. HTPR occurs in 25–35% of clopidogrel-treated patients, driven by CYP2C19 *2/*3 loss-of-function alleles (poor metabolizers: ~2–14% by ethnicity) reducing active metabolite formation.

Should all post-PCI patients have platelet function testing?

Routine platelet function testing is not recommended by ACC/AHA guidelines but may be considered in high-risk situations: recurrent stent thrombosis, complex bifurcation PCI, left main PCI, or suspected poor CYP2C19 metabolizer. CYP2C19 genotyping is more reproducible than phenotypic platelet testing for guiding escalation.

Clopidogrel Response HTPR Threshold Assessment

Identify high on-treatment platelet reactivity (HTPR) to clopidogrel using VerifyNow P2Y12 reaction units (PRU >208) or platelet aggregometry, and evaluate escalation to prasugrel or ticagrelor.

Use the full interactive calculator below, or

Clopidogrel Response HTPR Threshold Assessment

Frequently Asked Questions

What PRU threshold defines HTPR on clopidogrel?

Should all post-PCI patients have platelet function testing?