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Safety and efficacy of clopidogrel reloading in patients on chronic clopidogrel therapy who present with an acute coronary syndrome and undergo percutaneous coronary intervention.

Mahmoudi, M, Syed, AI, Ben-Dor, I, Gonzalez, M, Maluenda, G, Gaglia, MA, Sardi, G, Wakabayashi, K, Torguson, R, Xue, Z, Satler, LF, Suddath, WO, Pichard, AD and Waksman, R (2011) Safety and efficacy of clopidogrel reloading in patients on chronic clopidogrel therapy who present with an acute coronary syndrome and undergo percutaneous coronary intervention. Am J Cardiol, 107 (12). pp. 1779-1782.

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Abstract

The clinical safety and efficacy of clopidogrel reloading in patients receiving long-term clopidogrel therapy who present with acute coronary syndromes and undergo percutaneous coronary intervention have not yet been evaluated. The study cohort comprised 1,368 consecutive patients receiving long-term clopidogrel therapy (75 mg/day) who had presented with acute coronary syndromes and underwent coronary artery stent implantation. In total, 926 patients were given a 600-mg clopidogrel loading dose (reload cohort) before cardiac catheterization, while 442 patients were not reloaded (no-reload cohort). Patients who had presented with cardiogenic shock or stable angina were excluded. The 2 cohorts were well matched for the conventional risk factors for coronary artery disease. The analyzed clinical end points of death (1.1% vs 0.9%, p = 0.77), death or Q-wave myocardial infarction (0.9% vs 0.9%, p = 1.0), target lesion revascularization (0.2% vs 0.8%, p = 0.45), target vessel revascularization (1.1% vs 1.1%, p = 1.0), and major adverse cardiac events (2.0% vs 1.8%, p = 0.8) were similar between the no-reload and reload groups at 30 days. The in-hospital rates of major bleeding and gastrointestinal bleeding were also similar between the 2 cohorts. There were no cases of definite stent thrombosis. In conclusion, patients receiving long-term clopidogrel therapy who present with acute coronary syndromes do not gain any clinical benefit from additional reloading with clopidogrel.

Item Type: Article
Authors :
NameEmailORCID
Mahmoudi, Mm.mahmoudi@surrey.ac.ukUNSPECIFIED
Syed, AIUNSPECIFIEDUNSPECIFIED
Ben-Dor, IUNSPECIFIEDUNSPECIFIED
Gonzalez, MUNSPECIFIEDUNSPECIFIED
Maluenda, GUNSPECIFIEDUNSPECIFIED
Gaglia, MAUNSPECIFIEDUNSPECIFIED
Sardi, GUNSPECIFIEDUNSPECIFIED
Wakabayashi, KUNSPECIFIEDUNSPECIFIED
Torguson, RUNSPECIFIEDUNSPECIFIED
Xue, ZUNSPECIFIEDUNSPECIFIED
Satler, LFUNSPECIFIEDUNSPECIFIED
Suddath, WOUNSPECIFIEDUNSPECIFIED
Pichard, ADUNSPECIFIEDUNSPECIFIED
Waksman, RUNSPECIFIEDUNSPECIFIED
Date : 15 June 2011
Identification Number : https://doi.org/10.1016/j.amjcard.2011.02.327
Uncontrolled Keywords : Acute Coronary Syndrome, Aged, Angioplasty, Balloon, Coronary, Coronary Angiography, Female, Humans, Male, Middle Aged, Platelet Aggregation Inhibitors, Stents, Ticlopidine
Depositing User : Symplectic Elements
Date Deposited : 17 May 2017 09:47
Last Modified : 17 May 2017 09:47
URI: http://epubs.surrey.ac.uk/id/eprint/825101

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