Biological efficacy and clinical safety of a second 600 mg loading dose of clopidogrel in elderly patients with high on-treatment platelet reactivity: A pilot study

摘要

Elderly patients are.a growing proportion of patients undergoing percutaneous coronar/interventiqn (PCI) for an acute coronary syndrome (ACS) [1,2]. They have a higher risk of both ischemic and bleeding complications [2,3], Bespite these observations, patients over 75 years old are poorly represented or even excluded from major studies in the field. Recent studies suggested a higher rate of high on-treatment platelet reactivity (HTPR) in elderly patients compared to younger patients [4]. HTPR is strongly associated with cardiovascular death, myocardial infarction or stent thrombosis in patients undergoing PCI [5]. In addition, studies also suggested that excessive PR inhibition may favor bleedings [6]. The aim of the present pilot study was to evaluate the biological efficacy and clinical safety of a second loading dose (ID) of 600 mg of dopidogrel to overcome HTPR in elderly patients (>75 years old) undergoing PCI.