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The purpose of this study is to evaluate the effect of high dose clopidogrel as the antiplatelet therapy on inhibition of platelet aggregation in Japanese patients scheduled for percutaneous coronary intervention due to ischemic heart disease.
Dual antiplatelet therapy of aspirin and thienopyridine is used to prevent stent thrombosis after percutaneous coronary intervention (PCI). Clopidogrel is the most popular thienopyridine. Following the 300mg clopidogrel loading dose (LD) at first day, patients take 75mg maintenance dose (MD) to inhibit platelet aggregation after coronary stent implantation. 600mg high LD inhibit platelet aggregation more rapidly and strongly than standard LD and prevent thrombotic event around the PCI. Similarly high MD inhibit platelet aggregation more strongly. Interindividual variability of clopidogrel anti-platelet effect has been reported. In Japanese, there are many non or hyporesponders to clopidogrel compared to the Western population. The purpose of this study is to evaluate the effect of high dose clopidogrel as the antiplatelet therapy on inhibition of platelet aggregation in Japanese patients scheduled for PCI due to ischemic heart disease.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High loading and high maintenance | Active Comparator | Clopidogrel loading 600mg and maintenance 150mg for 7days |
|
| High loading and low maintenance | Active Comparator | Clopidogrel loading 600mg and maintenance 75mg for 7days |
|
| Low loading and high maintenance | Active Comparator | Clopidogrel loading 300mg and maintenance 150mg for 7days |
|
| Low loading and low maintenance | Active Comparator | Clopidogrel loading 300mg and maintenance 75mg for 7days |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Clopidogrel | Drug | Clopidogrel loading 600mg and maintenance 150mg for 7days |
|
| Measure | Description | Time Frame |
|---|---|---|
| Inhibition of platelet aggregation 24 hours after loading | 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Inhibition of platelet aggregation 7 days after loading | 7 days | |
| Inhibition of platelet aggregation 28 days after loading | 28 days | |
| all cause death |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Takeshi Kimura, MD | Professor of Medicine, Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Division of Cardiology, Kyoto University Hospital | Kyoto | Kyoto | 606-8507 | Japan |
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D000077144 | Clopidogrel |
| ID | Term |
|---|---|
| D013988 | Ticlopidine |
| D058924 | Thienopyridines |
| D013876 | Thiophenes |
| D013457 | Sulfur Compounds |
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| Clopidogrel | Drug | Clopidogrel loading 600mg and maintenance 75mg for 7days |
|
| Clopidogrel | Drug | Clopidogrel loading 300mg and maintenance 150mg for 7days |
|
| Clopidogrel | Drug | Clopidogrel loading 300mg and maintenance 75mg for 7days |
|
| 1 year |
| cardiac death | 1 year |
| myocardial infarction | 1 year |
| stent thrombosis (Academic Research Consortium definition) | 1 year |
| acute hemorrhagic or ischemic stroke excluding transient ischemic attack | 1 year |
| bleeding complications (Global Use of Strategies to Open Occluded Coronary Arteries [GUSTO] and Thrombolysis In Myocardial Infarction [TIMI] definition) | 1 year |
| composite of cardiac death, myocardial infarction and stroke | 1 year |
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D009930 |
| Organic Chemicals |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |