Clopidogrel Before Coronary Intervention Halves Risks

Researchers from University of Turin (Italy), and Virginia Commonwealth University (Richmond, USA) performed a meta-analysis of data from 10 studies involving more than 1,500 patients. Roughly half of the patients were pretreated with 300 mg of clopidogrel and the other half with 600 mg. A few received either 450 mg or 900 mg of clopidogrel.

Overall, pretreatment with high-dose clopidogrel (600 mg or more) was associated with a 50% reduction in the risk of cardiac death or nonfatal heart attack, both during the initial hospitalization and within 30 days of the PCI procedure. There was no statistically significant increase in major or minor bleeding. Findings remained the same when the analysis was restricted to seven randomized controlled trials only. Further analysis showed that the higher the underlying risk of complications related to blood clotting, the greater the benefit from high-dose clopidogrel. The study was presented at the 30th annual scientific sessions of the Society for Cardiovascular Angiography and Interventions (SCAI), held during May 2007 in Orlando (FL, USA).

"This research has important clinical and cost implications,” said co-author Giuseppe G. Biondi-Zoccai, M.D., an assistant professor of cardiology at the University of Turin. "The goal of antithrombotic management for PCI is to maximize protection from thrombotic complications during and shortly after PCI, while minimizing bleeding and costs.”

Clopidogrel interferes with the action of platelet cells, which stimulate the formation of blood clots. Interventional cardiologists give patients a loading dose of this medication before PCI to protect against blood clotting. After the procedure, most patients take a lower daily dose (75 mg) for up to a year, depending on the type of stent used to prop open the clogged coronary artery.


Related Links:
University of Turin
Virginia Commonwealth University