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

Title
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
Author(s)
김영조최철웅[최철웅]라승운[라승운]오동주[오동주]Kanhaiya L. Poddar[Kanhaiya L. Poddar]나진오[나진오]김진원[김진원]임홍의[임홍의]김응주[김응주]박창규[박창규]서홍석[서홍석]홍택종[홍택종]박종선허승호[허승호]성인환[성인환]채제건[채제건]조명찬[조명찬]배장호[배장호]최동훈[최동훈]장양수[장양수]채인호[채인호]김효수[김효수]김청진[김청진]윤정한[윤정한]안태훈[안태훈]Seung-Jea Tahk[Seung-Jea Tahk]정욱성[정욱성]승기배[승기배]Chung Chall Chae[Chung Chall Chae]박승정[박승정]안영근[안영근]정명호[정명호]
Keywords
PLATELET REACTIVITY; STENT THROMBOSIS; VARIABILITY; ANGIOPLASTY; RESISTANCE; REDUCTION; JAPANESE; OUTCOMES; TRIAL
Issue Date
201102
Publisher
MOSBY-ELSEVIER
Citation
AMERICAN HEART JOURNAL, v.161, no.2, pp.373 - U586
Abstract
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.)
URI
http://hdl.handle.net/YU.REPOSITORY/25664http://dx.doi.org/10.1016/j.ahj.2010.10.031
ISSN
0002-8703
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의과대학 > 내과학교실 > Articles
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