Effect of Different Maintenance Dose of Clopidogrel on Platelet Function in Patients with Acute Coronary Symptom Undergoing Percutaneous Coronary Intervention

Objective To investigate the platelet agregation effects with different doses of cloPidogrel in high-risk patients with acute coronary symptom undergoing percutaneous coronary intervention.Methods Sixty high-risk ACS patients undergoing drug-eluting stent(DES) implantation were randomly divided into groups A and B(30 cases in each group).Oral aspirin 100 mg and clopidogrel 600 mg before PCI,based on taking aspirin,clopidogrel were given 75 mg/d or 150 mg/d for 30 days after PCI.After 30 day all patients received clopidogrel 75 mg/d until 1 year after PCI.Respectively,before administration and 1 day,2 day,7 day,30 day after PCI,peripheral venous blood was collected to determine platelet aggregation(PA) with turbidimetric method and determine plasma soluble P-selectin(sP-s) concentrations with enzyme-linked immunosorbent assay.At same time platelet aggregation inhibition rate(PAI) was calculated.Primary endpoint included death,target organ revascularization.Secondary endpoints included serious and minor bleeding events.Results Before administration and 1 day after PCI,PA、PAI and the sP-s density had the non-significance difference(P0.05) between two groups,and at 2 day、7 day、30 day after PCI three indexes between two groups were a significant different(P0.05).At different time points in each group three indexes compared with more significant difference(P0.05).Via three months follow-up,the incidence of primary endpoint in 150 mg/d group was obviously lower than that in 75 mg group(13.33% vs 3.33%,P0.05),less increase in sub-end events(P0.05).Conclusion Platelet aggregation and the risk of adverse events could be reduced in high-risk patients used 150 mg/d maintenance dose clopidogrel undergoing percutaneous coronary intervention,And no increase the incidence of bleeding.