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Long term Dual antiplatelet therapy is critical post stenting to prevent stent thrombosis. However some patients due to a variety of reasons are unable to continue on the full dose of clopidogrel. Light transmission aggregometry (LTA) is the current gold standard for measuring platelet aggregation response to clopidogrel.
We aim in this study to compare the results of a select group of patients in whom clopidogrel was given in an abbreviated dose of 3 tablets/week & compared the LTA response to another group on standard daily 75 mg clopidogrel.
All patients received a 600 mg loading dose and 75 mg/ day maintenance dose. Group 1) 76 patients who received 75 mg/day clopidogrel. Group 2) 31 patients who received 75 mg tab. clopidogrel only 3/week due to associated medical conditions. LTA was done at 1 & 3 months post inclusion.
The mean age was 54 in Group (1) vs 53 in Group (2). There were significantly more diabetics in Group (1) vs Group (2) 41/76 vs 10/30 (P=.01) as well as more smokers 61% vs 42 % (P=.03). All patients received 150 mg Tagamet bid. LTA at 1 month: Group (1) 72% had an adequate response vs 67% in Group (2) P=NS. LTA at 3 Months: Group (1) 62% had an adequate response vs 59% in Group (2) P=NS. There were no cases of stent thrombosis in either group.
An abbreviated weekly dose of clopidogrel 3/week may provide a similar level of platelet aggregation inhibition relative to the standard daily dose at 1 & 3 months. However, the clinical implications require a larger group of patients.
- 2013 American College of Cardiology Foundation