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
- Cheol Ung Choi, a,
- Seung-Woon Rha, a,
- Dong Joo Oh, a,
, 
, - Kanhaiya L. Poddar, a,
- Jin Oh Na, a,
- Jin Won Kim, a,
- Hong Euy Lim, a,
- Eung Ju Kim, a,
- Chang Gyu Park, a,
- Hong Seog Seo, a,
- Taek Jong Hong, b, t,
- Jong-Seon Park, c, t,
- Young Jo Kim, c, t,
- Seung Ho Hur, d, t,
- In Whan Seong, e, t,
- Jei Keon Chae, f, t,
- Myeong Chan Cho, g, t,
- Jang Ho Bae, h,t,
- Dong Hoon Choi, i, t,
- Yang Soo Jang, i, t,
- In Ho Chae, j, t,
- Hyo Soo Kim, k, t,
- Chong Jin Kim, l, t,
- Jung Han Yoon, m, t,
- Tae Hoon Ahn, n, t,
- Seung-Jea Tahk, o, t,
- Wook Sung Chung,p, t,
- Ki Bae Seung, p, t,
- Shung Chall Chae, q, t,
- Seung Jung Park, r, t,
- Young Keun Ahn, s,t,
- Myung Ho Jeong, s, t
- a Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea
- b Cardiovascular Center, Pusan National University Hospital, Pusan, South Korea
- c Cardiovascular Center, Yeungnam University Hospital, Daegu, South Korea
- d Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu, South Korea
- e Cardiovascular Center, Chungnam National University Hospital, Daejeon, South Korea
- f Cardiovascular Center, Chonbuk National University Hospital, Jeonju, South Korea
- g Cardiovascular Center, Chungbuk National University Hospital, Chongju, South Korea
- h Cardiovascular Center, Konyang University Hospital, Daejeon, South Korea
- i Cardiovascular Center, Yonsei University Severance Hospital, Seoul, South Korea
- j Cardiovascular Center, Seoul National University Bundang Hospital, Bundang, South Korea
- k Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
- l Cardiovascular Center, Kyung Hee University East-West Neo Medical Center, Seoul, South Korea
- m Cardiovascular Center, Yonsei University Wonju Christian Hospital, Wonju, South Korea
- n Cardiovascular Center, Gacheon University Gil Hospital, Seoul, South Korea
- o Cardiovascular Center, Ajou University Hospital, Seoul, South Korea
- p Cardiovascular Center, Seoul St. Mary's Hospital, Seoul, South Korea
- q Cardiovascular Center, Kyungpook National University Hospital, Daegu, Korea
- r Cardiovascular Center, Ulsan University Asan Medical Center, Seoul, South Korea
- s Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
- Referred to by
- Standard versus high loading doses of clopidogrel in Asian patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: Insights from the Korea Acute Myocardial Infarction Registry
- American Heart Journal, Volume 162, Issue 1, July 2011, Page e17
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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.
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