Effect Of Different Doses Of Clopidogrel On The Prognosis Of PCI Patients With Different Diabetic States

Objective: This topic is to compare the impact of two different antiplatelet pretreatment strategies(loading dose 450 mg and standard dose of clopidogrel 300mg)in patients with coronary atherosclerotic heart disease(CHD)on platelet aggregation and clinical outcome after percutaneous coronary intervention(PCI).Methods:Select592patients with coronary heart disease for PCI,January 2016 to December 2016,the First Affiliated Hospital of Xinjiang Medical University Cardiac Center hospitalized,They were randomized to receive two different doses of clopidogrel antiplatelet therapy:standard-dose group:continuous double antiplatelet therapy(aspirin 100 mg,once daily plus clopidogrel 75 mg,Once a day)for more than 2 days,no additional treatment was performed within 24 hours before operation.The loading-dose group: based on the standard dose,an additional 150 mg of clopidogrel was added within 24 hours before surgery,blood samples were collected during the operation and determined MAR,finally interviewed the clinical outcome in one month.Results: In all PCI patients,compared with the standard dose group,the loading dose group significantly reduced MAR(P=0.02)and the incidence of ischemic events(P = 0.04),but there was no significant difference in the incidence of hemorrhagic events(P = 0.336).In PCI patients with diabetes,the loading dose group had a 25.3 reduction in MAR compared to the standard dose,and a12% reduction in the incidence of ischemic events(P = 0.009).In non-diabetic PCI patients,in the loading dose group,MAR(P = 0.02)had a significant benefits.Regarding the incidence of hemorrhagic events,there was no significant difference between the two groups in patients with diabetes mellitus PCI(P = 0.397),whereas in the risk of bleeding,DM or Non-DM both had no significant difference between the two groups(P =0.763 vs P =0.05).Conclusion: The preoperative loading dose clopidogrel can reduce MAR in PCI patients compared with the standard dose,and reduce the incidence ofischemic cardiovascular events after one month,without increasing the risk of bleeding.This advantage is even more pronounced in PCI patients with diabetes.For the PCI patients in our country,especially for DM patients in reducing the incidence of ischemic events.So for the different diabetic conditions combined with PCI,choosing a better personalized antiplatelet therapy strategy,we provide a theoretical basis.