The effect of high maintenance dose of clopidogrel on markers of inflammation in percutaneous coronary intervention perioperative period

Objective:To investigate the effect of high maintenance doses of clopidogrel(150 mg/d) on the markers of inflammation(hs-CRP,IL-6、TNF-α) in high-risk patients with acute coronary symptom(ACS) undergoing percutaneous coronary intervention(PCI).Methods:A total of 80 high-risk(through the GRACE' classification process) ACS patients undergoing drug-eluting stent implantation were randomly divided to the colpidogrel 75 mg/d group(n=40) and the colpidogrel 150 mg/d group(n=40),treated as for 30 days after PCI.After 30 days all patients received clopidogrel 75 mg/d for long-term maintenance treatment.The peripheral venous blood was collected to determine hs-CRP,IL-6 and TNF-α for all patients before PCI and 30 days after PCI.The results thus obtained were analyzed and compared accordingly.Via 6 months follow-up,the incidence of MACE and bleeding events in two groups were recorded.Results:1.hs-CRP,IL-6,TNF-α in the colpidogrel 150 mg/d group and 75 mg/d group were not significantly significant difference before PCI(P0.05);2.hs-CRP,IL-6,TNF-α were significantly decreased in the two groups one month after PCI(P0.01),hs-CRP,IL-6,TNF-α were significantly restrained in the colpidogrel 150 mg/d group than the colpidogrel 75 mg/d group(P0.05);3.The incidence of MACE was significantly different between the two groups(P0.05),there were not significant difference in the incidence of hemorrhage between the two groups(P0.05).Conclusion:The high maintenance dose of clopidogrel can further reduce the inflammation of arteries and not increase the risk of bleeding.Accordingly,it helps to decrease MACE in short time for high-risk ACS patients.