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Tailored Clopidogrel Dosing Improves PCI Outcomes
Date:3/29/2008

Blood test monitors each patient's response to anti-clotting drug

CHICAGO, March 29 /PRNewswire/ -- Using a simple blood test to individualize the loading dose of a medication that prevents blood clotting significantly reduces the risk of major cardiovascular complications after percutaneous coronary interventions (PCI), according to a multicenter study reported today in a Late-Breaking Clinical Trials session at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit (SCAI-ACCi2) in Chicago. SCAI-ACCi2 is a scientific meeting for practicing cardiovascular interventionalists sponsored by the Society for Cardiovascular Angiography and Interventions (SCAI) in partnership with the American College of Cardiology (ACC). The study will simultaneously publish in the Journal of the American College of Cardiology.

The study showed that in some patients, an initial, or loading, dose several times higher than usual is necessary to ensure the effectiveness of clopidogrel, a medication that prevents platelets from clumping together to form blood clots. The payoff for tailoring the clopidogrel dose: a significant reduction one month after PCI in the combined rates of heart attack, death, and need for repeat procedures to open the coronary arteries, with no increased risk of bleeding.

"Tailoring the loading dose of clopidogrel using platelet monitoring seems to be the best way to decrease the rate of major adverse cardiac events, in particular, stent thrombosis, which is the worst complication after PCI," said Laurent Bonello, MD, a cardiologist at Hopital Universitaire Nord, and Universite de la Mediterranee, both in Marseille, France.

Giving a large dose of clopidogrel before coronary stenting is standard procedure in cardiac catheterization laboratories. However, there is substantial variability among patients in the response to the anti-clotting drug. Previous studies have shown that a poor response to clopidogrel is linked to
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SOURCE SCAI-ACCi2
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