Comparison of 600 versus 300-mg Clopidogrel loading dose in patients with ST-segment elevation myocardial infarction undergoing primary coronary angioplasty.
Details
Serval ID
serval:BIB_A8A4494F5CA1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Comparison of 600 versus 300-mg Clopidogrel loading dose in patients with ST-segment elevation myocardial infarction undergoing primary coronary angioplasty.
Journal
American Journal of Cardiology
ISSN
1879-1913 (Electronic)
ISSN-L
0002-9149
Publication state
Published
Issued date
2010
Volume
106
Number
9
Pages
1208-1211
Language
english
Abstract
The aim of the present study was to compare 600- and 300-mg clopidogrel loading doses in patients with ST-segment elevation myocardial infarctions who underwent primary percutaneous coronary intervention (PCI). Two hundred fifty-five consecutive patients presenting with ST-segment elevation myocardial infarctions who underwent primary PCI were enrolled. Patients were divided into 2 groups on the basis of the loading dose of clopidogrel received before the procedure (600 vs 300 mg). Procedural angiographic end points and 1-year major adverse cardiac events were compared between the 2 groups. Major adverse cardiac events were defined as death, nonfatal myocardial infarction, and target vessel revascularization. There were no significant differences in baseline clinical and angiographic features between the 2 groups: 157 (62%) in the clopidogrel 600 mg group and 98 (38%) in the 300 mg group. Patients receiving 600-mg loading dose of clopidogrel showed a significantly lower incidence of post-PCI myocardial blush grade 0 or 1 (odds ratio 0.64, 95% confidence interval 0.43 to 0.96, p = 0.03) and significantly less common no-reflow phenomenon (odds ratio 0.38, 95% confidence interval 0.15 to 0.98, p = 0.04) compared to those in the 300-mg group. Propensity-adjusted Cox analysis showed significantly higher survival free of major adverse cardiac events in patients receiving 600-mg loading dose of clopidogrel compared to those receiving the lower dose (hazard ratio 0.57, 95% confidence interval 0.33 to 0.98, p = 0.04). In conclusion, a 600-mg loading dose of clopidogrel is associated with improvements in procedural angiographic end points and 1-year clinical outcomes in patients with ST-segment elevation myocardial infarction who undergo primary PCI compared to a 300-mg dose.
Keywords
Aged, Angioplasty, Balloon, Coronary, Chi-Square Distribution, Combined Modality Therapy, Coronary Angiography, Female, Humans, Logistic Models, Male, Middle Aged, Myocardial Infarction/drug therapy, Myocardial Infarction/therapy, No-Reflow Phenomenon, Platelet Aggregation Inhibitors/administration & dosage, Proportional Hazards Models, Prospective Studies, Registries, Survival Rate, Ticlopidine/administration & dosage, Ticlopidine/analogs & derivatives, Treatment Outcome
Pubmed
Web of science
Create date
16/02/2015 17:58
Last modification date
20/08/2019 15:13