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

ARI H., Ozkan H., Karacinar A., Ari S., Koca V., BOZAT T.

International Journal of Cardiology, cilt.157, sa.3, ss.374-380, 2012 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 157 Sayı: 3
  • Basım Tarihi: 2012
  • Doi Numarası: 10.1016/j.ijcard.2010.12.083
  • Dergi Adı: International Journal of Cardiology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.374-380
  • Anahtar Kelimeler: Clopidogrel, Resistance, PCI, MACCE
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

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). © 2010 Elsevier Ireland Ltd. All rights reserved.