If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  High-Dose Clopidogrel Reduces Vascular Events in Patients Undergoing PCI: Presented at ESC By Ed Susman BARCELONA, Spain -- August 31, 2009 -- Researchers suggest that doubling the standard treatment regimen of clopidogrel for individuals undergoing percutaneous coronary interventions (PCIs) can markedly reduce adverse cardiovascular events. "For every 1,000 patients with acute coronary syndromes receiving percutaneous coronary interventions, using double-dose clopidogrel for 7 days instead of standard dose will prevent an additional 6 myocardial infarctions and 7 stent thromboses," said Shamir R. Mehta, MD, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario. However, that treatment with the higher dose of clopidogrel would be associated with an excess of 3 severe, nonfatal bleeding incidents among those 1,000 patients, he said in a Hot Line oral presentation on August 30 here at the 2009 Congress of the European Society of Cardiology (ESC). In the phase 3 Clopidogrel Optimal Loading Dose Usage to Reduce Recurrent Events/Optimal Antiplatelet Strategy for Interventions (CURRENT-OASIS 7) trial, Dr. Mehta and colleagues from 39 countries enrolled 25,087 patients scheduled to undergo angiography within 72 hours of arriving in a hospital emergency department or coronary care unit with unstable angina or myocardial infarction (MI). Of those patients, 17,232 underwent angioplasty. Upon arrival at the hospital, 12,579 patients were randomly assigned to the standard dose of clopidogrel and 12,508 were assigned to receive clopidogrel for 1 month. High-dose patients received clopidogrel 600 mg on the first day, as early as possible before angioplasty, then 150 mg once a day for 7 days, followed by 75 mg daily for the remainder of the month. Patients on the standard regimen received clopidogrel 300 mg on day 1, followed by 75 mg once a day until day 30. Patients in both groups were randomly assigned to either high-dose aspirin (300-325 mg once daily) or low-dose aspirin (75-100 mg once daily). Dr. Mehta said the high-dose clopidogrel regimen reduced the risk of stent thrombosis by an incremental 30% and the risk of MI by a further 22% above the standard regimen. Funding for this study was provided by Sanofi-Aventis and Bristol-Myers Squibb. [Presentation title: CURRENT OASIS 7: A 2 x 2 Factorial Randomized Trial of Optimal Clopidogrel and Aspirin Dosing in Patients With ACS Undergoing an Early Invasive Strategy With Intent for PCI]
|
