title: Standard versus high loading doses of clopidogrel in Asian ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention: insights from the Korea Acute Myocardial Infarction Registry.
abstract: BACKGROUND
  The optimal loading dose of clopidogrel in Asian patients with ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. We compared bleeding, vascular complications, and midterm outcomes of a 300-mg versus a 600-mg loading dose of clopidogrel in a large series of Korean patients with STEMI undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  A total of 2,664 STEMI patients (age 61.96 ± 11.91 years, men 70.4%) who underwent primary PCI were enrolled in this study. The patients were divided into a standard loading dose group (300 mg; n = 1,447 patients) and a high loading dose group (600 mg; n = 1,217 patients). Bleeding and vascular complications, and in-hospital and clinical outcomes up to 12 months were compared between the 2 groups.
  
  
  RESULTS
  In-hospital bleeding and vascular complications were similar between the 2 groups. There were no differences in bleeding and vascular complications and in 1- and 12-month clinical outcomes, including mortality, myocardial infarction, repeated PCI, and major adverse cardiac events, between the 2 groups. These findings were consistent even after the propensity score-matched analysis.
  
  
  CONCLUSIONS
  The standard loading dose of clopidogrel may be as safe and similarly effective as the high loading dose in Asian STEMI patients undergoing primary PCI.
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea.
authors.forename: Cheol Ung
authors.initials: CU
authors.lastname: Choi
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
authors.forename: Kanhaiya L
authors.initials: KL
authors.lastname: Poddar
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Na
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Hong Euy
authors.initials: HE
authors.lastname: Lim
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.forename: Chang Gyu
authors.initials: CG
authors.lastname: Park
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.forename: Jong-Seon
authors.initials: JS
authors.lastname: Park
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.forename: Jei Keon
authors.initials: JK
authors.lastname: Chae
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Jang Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Choi
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Jang
authors.forename: In Ho
authors.initials: IH
authors.lastname: Chae
authors.forename: Hyo Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Yoon
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Ahn
authors.forename: Seung-Jea
authors.initials: SJ
authors.lastname: Tahk
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Shung Chall
authors.initials: SC
authors.lastname: Chae
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Park
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D000077144:Clopidogrel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine