The EFFect of hIgh-dose ClopIdogrel treatmENT in patients with clopidogrel resistance (The EFFICIENT Trial)

被引：51

作者：

Ari, Hasan ^{[1
]}

Ozkan, Hakan ^{[2
]}

Karacinar, Ali ^{[1
]}

Ari, Selma ^{[1
]}

Koca, Vedat ^{[1
]}

Bozat, Tahsin ^{[1
]}

机构：

[1] Bursa Postgrad Hosp, Dept Cardiol, Bursa, Turkey

[2] Med Pk Hosp, Dept Cardiol, Bursa, Turkey

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2012年 / 157卷 / 03期

关键词：

Clopidogrel; Resistance; PCI; MACCE; PERCUTANEOUS CORONARY INTERVENTION; MYOCARDIAL-INFARCTION; ARTERY-DISEASE; PLATELET INHIBITION; ASPIRIN RESISTANCE; STENT THROMBOSIS; DOUBLE-BLIND; RISK; RESPONSIVENESS; TICLOPIDINE;

D O I：

10.1016/j.ijcard.2010.12.083

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: The aim of this study was to evaluate the effect of high-dose clopidogrel continuation treatment on the development of MACCE after elective PCI in patients with clopidogrel resistance. Methods: The study group consisted of 192 patients. Of these, 98 participants without resistance served as the control group (Group 1) and received 75 mg/day clopidogrel for 1 month. Ninety-four patients with resistance were randomly divided into two groups: 47 patients in the standard-dose group (Group 2) received 75 mg/day continuation therapy, whereas 47 patients in the high-dose group (Group 3) received 150 mg/day continuation therapy for 1 month. Clopidogrel resistance was evaluated with the VerifyNow P2Y12 test. Patients with a platelet inhibition value lower than 40% were classified as resistant. Results: During the 6-month follow-up for MACCE, the event-rate in Group 2 was significantly higher than both Groups 1 and 3 (Group 1 vs Group 2; p=0.019, Group 1 vs Group 3; p=0.82, Group 2 vs Group 3; p=0.045). Total bleeding rate in all groups were similar (Group 1 vs Group 2; p=0.54, Group 1 vs Group 3; p=0.27, Group 2 vs Group 3; p=0.16). The rate of NACE was similar in all groups (Group 1 vs Group 2; p=0.08, Group 1 vs Group 3; p=0.50, Group 2 vs Group 3; p=0.39). Conclusion: In patients who underwent elective PCI and had clopidogrel resistance, high-dose clopidogrel continuation therapy was more efficient in preventing MACCE than the standard dose. High-dose continuation therapy did not increase the risk of bleeding complication (The EFFICIENT Trial; ClinicalTrials.gov number: NCT01032668). (C) 2010 Elsevier Ireland Ltd. All rights reserved.

引用

页码：374 / 380

页数：7

共 39 条

[11] Benefit of a 600-mg loading dose of clopidogrel on platelet reactivity and clinical outcomes in patients with non-ST-segment elevation acute coronary syndrome undergoing coronary stenting [J].