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  • High clopidogrel loading do...
    Angiolillo, Dominick J.; Fernández-Ortiz, Antonio; Bernardo, Esther; Ramírez, Celia; Sabaté, Manel; Bañuelos, Camino; Hernández-Antolín, Rosana; Escaned, Javier; Moreno, Raul; Alfonso, Fernando; Macaya, Carlos

    European heart journal, 11/2004, Letnik: 25, Številka: 21
    Journal Article

    Aim To assess platelet inhibitory effects, interindividual variability in platelet inhibition as well as response to a 600 mg, compared to a standard 300 mg, clopidogrel loading dose (LD) after coronary stenting Methods and results Platelet function profiles were assessed in 50 patients undergoing coronary stenting receiving either a 300 mg (n=27) or 600 mg clopidogrel LD. ADP (6 μM) and collagen (6 μg/mL) induced platelet aggregation, as well as ADP (2 μM) induced glycoprotein (GP) IIb/IIIa activation and P-selectin expression were assessed at baseline and 4, 24, and 48 h following clopidogrel front-loading. A more intense and rapid inhibition of platelet activation (both GP IIb/IIIa activation and P-selectin expression) were achieved using a 600 mg, compared to a 300 mg, LD throughout the entire 48 hours (p<0.001). Although there were no differences in platelet aggregation, overall a 600 mg LD increased the number of clopidogrel responders and this was also achieved earlier compared to a 300 mg LD. A 600 mg LD did not reduce interindividual variability of platelet response. Conclusion The use of a 600 mg clopidogrel LD in patients undergoing coronary stenting optimises platelet inhibitory effects early after intervention and may provide a more effective protection against early thrombotic complications.