Effect of Different Dosing Regimens of Clopidogrel Before Elective Percutaneous Coronary Intervention (PCI) on Platelet Function

Effect of Different Dosing Regimens of Clopidogrel Given Before Elective Percutaneous Coronary Intervention on Platelet Function

Adequate platelet inhibition before percutaneous coronary intervention (PCI) reduces peri-procedural and long-term ischemic complications. Documented reduced response to clopidogrel has been associated with subsequent major adverse cardiovascular events. Strategies to optimize platelet inhibition pre-PCI are under investigation.

This study sought to evaluate the effect on platelet aggregation of four different dosing regimens of clopidogrel given before elective PCI.

Inclusion Criteria:

• Adult patient with an indication for elective coronary angiography with or without PCI

Exclusion Criteria:

• major hemorrhagic diathesis or active bleeding
• acute myocardial infarction (MI) within 14 days of enrolment
• unstable angina with ST-segment changes >1 mm in at least two contiguous electrocardiographic leads at rest or a troponin I level >0.06 microg/L within 14 days of enrolment
• stroke within the past 3 months
• platelet count <100 x 10 9/L
• prothrombin time > 1.5 times control
• hematocrit <25% or hemoglobin level <100 g/L
• alcohol or drug abuse
• enrolment in other investigational drug trials within the previous month
• use of thienopyridines, glycoprotein (GP) IIb/IIIa inhibitors, warfarin or acenocoumarol within the previous week
• allergic reaction or any contraindication to clopidogrel or aspirin administration