Efficacy and safety of double-dosage Clopidogrel in elderly patients with Clopidogrel resistance after percutaneous coronary intervention

Objective To evaluate the efficacy and safety of double-dosage Clopidogrel in elderly patients with Clopidogrel resistance after percutaneous coronary intervention(PCI). Methods The randomized control trials design was used in this study.108 senile ACS patients with Clopidogrel resistance(platelet inhibition rate<30%)were randomized into control group(Clopidogrel 75 mg/d, n=54)and experimental group(Clopidogrel 150 mg/d, n=54). Blood platelet inhibition rate of ADP, major adverse cardiovascular events and main side effects were observed before and 7 d, 30 d, 90 d and 180 d after intervention. Results Compared with control group, the experimental group was associated with significantly increased platelet inhibition rate on 7 d(22.4±4.5)% vs.(37.6±4.5)%, 30 d(22.6±4.3)% vs.(38.8±4.7)%, 90 d(22.7±4.6)% vs.(38.5±4.5)%, and 180 d(23.7±4.3)% vs.(38.9±4.6)% after treatment(all P<0.05). Furthermore, the incidence of main adverse cardiovascular events was also significantly lower in the experimental group(3.7% vs.35.1%, χ2=15.133, P<0.001). Meanwhile, the incidence of bleeding and dyspnea were higher in experimental group, but there was no significant difference between the two groups. Conclusions Compared with general dosage, double-dosage of Clopidogrel offers better curative effect and good safety in elderly ACS patients with Clopidogrel resistance after PCI. Key words: Acute coronary syndrome; Angioplasty; Platelet aggregation inhibitors; Thrombelastography