title: High clopidogrel dose in patients with chronic kidney disease having clopidogrel resistance after percutaneous coronary intervention.
abstract: We evaluated the impact of clopidogrel 150 mg/d in patients with chronic kidney disease (CKD) having clopidogrel resistance (CR) after percutaneous coronary intervention (PCI); 1076 consecutive patients with coronary artery disease (CAD) having CKD were enrolled. Maximal platelet aggregation (MPA) was assessed before, 24 hours, and 30 days after a 300-mg loading dose of clopidogrel prior to PCI. After PCI, 370 patients with CR were randomized to receive clopidogrel 75 mg/d (n = 184) or 150 mg/d (n = 186) for 30 days. Stent thrombosis (ST), major adverse cardiac events (MACEs), and bleeding were analyzed after 1 month. Patients in the 150 mg group had significant lower rates of ST and MACE. There was no significant difference in major or minor bleeding. Patients in the 150 mg group had lower MPA and greater inhibition of platelet aggregation. One-month administration of 150 mg/d of clopidogrel decreases the rate of ST and MACE without increasing bleeding in patients with CKD having CR after PCI.
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liang
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Shi
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuyang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yingxin
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Hongya
authors.initials: H
authors.lastname: Han
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yueping
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China azgbjl12@163.com.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000368:Aged; D002681:China; D000077144:Clopidogrel; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D003328:Coronary Thrombosis / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D004334:Drug Administration Schedule; D004351:Drug Resistance; D054855:Drug-Eluting Stents; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D010979:Platelet Function Tests; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: chronic kidney disease; clopidogrel resistance; coronary artery disease; percutaneous coronary intervention; stent thrombosis