Double Loading Dose And Maintenance Dose Clopidogrel In Patients With Acute Coronary Syndrome Comparedshort-term Effect Of Percutaneous Coronary Angioplasty

Objective:Aim to investigate whether a higher clopidogrel maintenance dosage is associated with a significant reduced the rate of platelet aggregation after percutaneous coronary intervention(PCI) in patients with acute coronary syndrome and to evaluate its efficacy and safety in ashort-term in this study.Methods:We selected 214 patients with acute coronary syndrome who treated with percutaneous coronary intervention(PCI),all subjects were selected from the department of cardiology of the first hospital of Handan City between December 2012 and June 2013.They were randomly divided into two groups:group A(conventional dose group) were given 600 mg clopidogrel loading dose before PCI and 75 mg clopidogrel maintenance dose for 30 days after PCI; group B(double dose group) were given 600 mg clopidogrel loading dose before PCI and 150 mg clopidogrel maintenance dose for 30 days after PCI.After 30 days all patients received 75mg/day of clopidogrel treatment until after one year. To observe:(1) Platelet aggregation rate:The basic platelet aggregation rate were mearsured on admitted to hospital.then the platelet aggregation rate of 2 hours after taking 600 mg clopidogrel were mearsured,as well as 24 hours、7 days、14 days、and 30 days after taking different clopidogrel maintenance dose were mearsured.(2) Clinical follow-up:all the patients were followed up in 30 days.We observed the incidence of major adverse cardiac events(MACE) and the bleeding events in the different maintenance dose group.Results:1 There were no significant difference in the basic platelet aggregation rate、the platelet aggregation of 2 hours after taking 600 mg clopidogrel、24 hours and 7 days after taking different clopidogrel maintenance dose; there were significant difference between two groups on the 14 days and the 30 days after taking different clopidogrel maintenance dose.2 Double dose group did not significant reduce the incidence of major adverse cardiac events(MACE) and did not significant increase the incidence of bleeding events compared with the conventional dose group.Conclusions:Double maintenance dose clopidogrel significant reduced the platelet aggregation but did not reduce the incidence of major adverse cardiac events(MACE) obviously and do not increased the incidence of bleeding events compared with the conventional maintenance dose clopidogrel.