Standard versus high loading doses of clopidogrel in Asian ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention: Insights from the Korea Acute Myocardial Infarction Registry

被引：15

作者：

Choi, Cheol Ung ^{[1
]}

Rha, Seung-Woon ^{[1
]}

Oh, Dong Joo ^{[1
]}

Poddar, Kanhaiya L. ^{[1
]}

Na, Jin Oh ^{[1
]}

Kim, Jin Won ^{[1
]}

Lim, Hong Euy ^{[1
]}

Kim, Eung Ju ^{[1
]}

Park, Chang Gyu ^{[1
]}

Seo, Hong Seog ^{[1
]}

Hong, Taek Jong ^{[2
]}

Park, Jong-Seon ^{[3
]}

Kim, Young Jo ^{[3
]}

Hur, Seung Ho ^{[4
]}

Seong, In Whan ^{[5
]}

Chae, Jei Keon ^{[6
]}

Cho, Myeong Chan ^{[7
]}

Bae, Jang Ho ^{[8
]}

Choi, Dong Hoon ^{[9
]}

Jang, Yang Soo ^{[9
]}

Chae, In Ho ^{[10
]}

Kim, Hyo Soo ^{[11
]}

Kim, Chong Jin ^{[12
]}

Yoon, Jung Han ^{[13
]}

Ahn, Tae Hoon ^{[14
]}

Tahk, Seung-Jea ^{[15
]}

Chung, Wook Sung ^{[16
]}

Seung, Ki Bae ^{[16
]}

Chae, Shung Chall ^{[17
]}

Park, Seung Jung ^{[18
]}

Ahn, Young Keun ^{[19
]}

Jeong, Myung Ho ^{[19
]}

机构：

[1] Korea Univ, Guro Hosp, Ctr Cardiovasc, Seoul 152703, South Korea

[2] Pusan Natl Univ Hosp, Ctr Cardiovasc, Pusan, South Korea

[3] Yeungnam Univ Hosp, Ctr Cardiovasc, Taegu, South Korea

[4] Keimyung Univ, Dongsan Hosp, Ctr Cardiovasc, Taegu, South Korea

[5] Chungnam Natl Univ Hosp, Ctr Cardiovasc, Taejon, South Korea

[6] Chonbuk Natl Univ Hosp, Ctr Cardiovasc, Jeonju, South Korea

[7] Chungbuk Natl Univ Hosp, Ctr Cardiovasc, Chonju, South Korea

[8] Konyang Univ Hosp, Ctr Cardiovasc, Taejon, South Korea

[9] Yonsei Univ, Severance Hosp, Ctr Cardiovasc, Seoul 120749, South Korea

[10] Seoul Natl Univ, Bundang Hosp, Ctr Cardiovasc, Bundang, South Korea

[11] Seoul Natl Univ Hosp, Ctr Cardiovasc, Seoul 110744, South Korea

[12] Kyung Hee Univ, EW Neo Med Ctr, Ctr Cardiovasc, Seoul, South Korea

[13] Yonsei Univ, Wonju Christian Hosp, Ctr Cardiovasc, Wonju, South Korea

[14] Gacheon Univ Gil Hosp, Ctr Cardiovasc, Seoul, South Korea

[15] Ajou Univ Hosp, Ctr Cardiovasc, Seoul, South Korea

[16] Seoul St Marys Hosp, Ctr Cardiovasc, Seoul, South Korea

[17] Kyungpook Natl Univ Hosp, Ctr Cardiovasc, Taegu, South Korea

[18] Univ Ulsan, Asan Med Ctr, Ctr Cardiovasc, Seoul, South Korea

[19] Chonnam Natl Univ Hosp, Ctr Cardiovasc, Kwangju, South Korea

来源：

AMERICAN HEART JOURNAL | 2011年 / 161卷 / 02期

关键词：

PLATELET REACTIVITY; STENT THROMBOSIS; VARIABILITY; ANGIOPLASTY; RESISTANCE; REDUCTION; JAPANESE; OUTCOMES; TRIAL;

D O I：

10.1016/j.ahj.2010.10.031

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background The optimal loading dose of clopidogrel in Asian patients with ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. We compared bleeding, vascular complications, and midterm outcomes of a 300-mg versus a 600-mg loading dose of clopidogrel in a large series of Korean patients with STEMI undergoing primary percutaneous coronary intervention (PCI). Methods A total of 2,664 STEMI patients (age 61.96 +/- 11.91 years, men 70.4%) who underwent primary PCI were enrolled in this study. The patients were divided into a standard loading dose group (300 mg; n = 1,447 patients) and a high loading dose group (600 mg; n = 1,217 patients). Bleeding and vascular complications, and in-hospital and clinical outcomes up to 12 months were compared between the 2 groups. Results In-hospital bleeding and vascular complications were similar between the 2 groups. There were no differences in bleeding and vascular complications and in 1- and 12-month clinical outcomes, including mortality, myocardial infarction, repeated PCI, and major adverse cardiac events, between the 2 groups. These findings were consistent even after the propensity score-matched analysis. Conclusions The standard loading dose of clopidogrel may be as safe and similarly effective as the high loading dose in Asian STEMI patients undergoing primary PCI. (Am Heart J 2011;161:373-382.e3.)

引用

页码：373 / U586

页数：13

共 19 条

[1] Impact of platelet reactivity after clopidogrel administration on drug-eluting stent thrombosis [J].