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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.

Choi, CU; Rha, SW; Oh, DJ; Poddar, KL; Na, JO; Kim, JW; Lim, HE; Kim, EJ; Park, CG; Seo, HS; Hong, TJ; Park, JS; Kim, YJ; Hur, SH; Seong, IW; Chae, JK; Cho, MC; Bae, JH; Choi, DH; Jang, YS; Chae, IH; Kim, HS; Kim, CJ; Yoon, JH; Ahn, TH; Tahk, SJ; Chung, WS; Seung, KB; Chae, SC; Park, SJ; Ahn, YK; Jeong, MH
American heart journal, 161(2):373-382.e1-3, 2011
Journal Title
American heart journal
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.
MeSH terms
*Angioplasty, Balloon, CoronaryFemaleHumansMaleMiddle AgedMyocardial Infarction/physiopathology/*therapyPlatelet Aggregation Inhibitors/*administration & dosageRegistriesRepublic of KoreaRetrospective StudiesTiclopidine/administration & dosage/*analogs & derivatives
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Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
탁, 승제
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