title: Effects of high loading dose of clopidogrel in ST elevated myocardial infarction treated with fibrinolytic agent.
abstract: OBJECTIVE
  The purpose of the present study was to evaluate the effects of different loading doses of clopidogrel on ST segment resolution on ECG, changes in cardiac enzyme levels and serum levels of high-sensitivity C-reactive protein (Hs-CRP) in patients with ST elevated myocardial infarction (STEMI) treated with fibrinolytic therapy.
  
  
  METHODS
  Patients admitted to our cardiology clinic with a diagnosis of STEMI and treated with fibrinolytic therapy were included: Group 1 (n=58) received a 300 mg loading dose of clopidogrel, Group 2 (n=55) a 450 mg loading dose and Group 3 (n=59) a 600 mg loading dose. A 75 mg/d maintanence dose of clopidogrel was given in all groups.
  
  
  RESULTS
  All demographic characteristics and baseline laboratory parameters were statistically similar among three groups (p > 0.05). When ST resolution periods were compared, most patients in Group 3 had ST resolution at 30 minutes; Group 2 at 60 minutes and Group 1 at 90 minutes (p < 0.05). Peak levels of creatine kinase (CK) and CK-MB were as follows: Group 3, 8(th) hour, Group 1 and 2, 12(th) hour. Peak levels of those enzymes were significantly lower in Group 3 than in Group 1 and 2 ( < 0.05). Although basal hs-CRP levels of all groups were similar, the increase in hs-CRP levels at 48 hours was lower with higher clopidogrel loading doses (p < 0.05).
  
  
  CONCLUSIONS
  In this study comparing three different clopidogrel loading doses, the higher doses provided earlier ECG resolution, earlier and lower peak CK and CK-MB levels and lower levels of hs-CRP.
authors: Firat University Medical Faculty, Department of Cardiology, Elazig, Turkey.
authors: Hatice
authors: H
authors: Solmaz
authors: Mehmet
authors: M
authors: Akbulut
authors: Hasan
authors: H
authors: Korkmaz
authors: Mustafa F
authors: MF
authors: Yavuzkir
authors: Oğuz K
authors: OK
authors: Kaya
authors: Ertuğrul
authors: E
authors: Kurtoğlu
authors: Zülfiye
authors: Z
authors: Kuzu
authors: Makbule K
authors: MK
authors: Karadağ
authors: Ayhan
authors: A
authors: Uysal
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D000077144:Clopidogrel; D004334:Drug Administration Schedule; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000378:metabolism; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D002097:C-Reactive Protein; D000077144:Clopidogrel; D013988:Ticlopidine