Early effect of high maintenance dose of clopidogrel in patients with acute coronary syndrome underwent drug-eluting stent implantation

Objective To investigate the short-term efficacy and safety of high maintenance dose (150 mg)of clopidogre in patients with acute coronary syndrome (ACS)undergoing drug-eluting stent (DES) implantation.Methods Ninety-six ACS patients underwent DES implantation were enrolled in the study.Loading dose (300 mg) of clopidiogrel was administered before percutaneous coronary intervention(PCI).Patients were then randomized to receive clopidiogrel 75 mg(75 mg group) or 150 mg (150 mg group)per day for 7 days in addition to 300 mg aspirin daily.From 8 -30 d after surgery,all patients received 75 mg/d clopidogrel.Adenosine diphosphate( ADP)-induced maximal platelet aggregation rate (MPAR) was measured before PCI and 7 days after PCI.The incidence of major clinical cardiovascular events (MACE) and hemorrhagic events were studied at 30 days after operation.Results MPAR was decreased obviously in the 150 mg group ( P ＜ 0.05 ) at 7 days after PCI.The incidence of MACE in 150 mg group was significantly lower than that in the 75 mg group (P ＜ 0.05).ConclusionsHigh maintenance dose of 150 mg clopidogrel daily in the first week after PCI procedure can reduce the risk of adverse events in patients with ACS underwent DES implantation and is safe. Key words: Clopidogrel;  High maintenance dose;  Drug-eluting stent