Effect of timing of clopidogrel administration on 30-day clinical outcomes: 300-mg loading dose immediately after coronary stenting versus pretreatment 6 to 24 hours before stenting in a large unselected patient cohort

Tar, Balázs; Gyöngyösi, Mariann; Homoródi, Nóra; Kristóf, Endre; Király, Csaba; Facskó, Andrea; Pávó, Noémi; Sodeck, Gottfried; Strehblow, Christoph; Farhan, Serdar; Maurer, Gerald; Glogar, Dietmar; Domanovits, Hans; Huber, Kurt; Édes, István

doi:10.1016/j.ahj.2006.10.030

Cited by 47 publications

(24 citation statements)

References 26 publications

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“…The speed of onset of prasugrel's antiplatelet effect offers the clinician the opportunity to determine that the coronary anatomy is suitable for PCI before committing to irreversible P2Y 12 inhibition. This strategy overcomes the liability of a commonly used strategy of pre-treating with clopidogrel before PCI, which exposes patients to substantially increased risks of perioperative bleeding if urgent CABG surgery is required as well as non-CABG-related bleeding (15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Early and Late Benefits of Prasugrel in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

Antman

Wiviott

Murphy

et al. 2008

Journal of the American College of Cardiology

297

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Both the loading dose and maintenance dose of prasugrel were superior to clopidogrel for the reduction of ischemic events. This result emphasizes the importance of maintaining high levels of inhibition of platelet aggregation via P2Y(12) receptor inhibition, not only for the prevention of periprocedural ischemic events but also during long-term follow-up. The excess major bleeding observed with the use of prasugrel occurred predominantly during the maintenance phase. Approaches to reduce the relative excess of bleeding with prasugrel should focus on the maintenance dose (e.g., reduction in maintenance dose in previously reported high-risk subgroups, such as the elderly and those patients with low body weight). (A Comparison of CS-747 and Clopidogrel in Acute Coronary Syndrome Subjects Who Are to Undergo Percutaneous Coronary Intervention; NCT00097591).

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Section: Discussionmentioning

confidence: 99%

Early and Late Benefits of Prasugrel in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

Antman

Wiviott

Murphy

et al. 2008

Journal of the American College of Cardiology

297

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“…On the other hand, in patients with stable CAD who are scheduled for PCI, the pathophysiology of disease is completely different, CV risk is low, and peri-procedural ischemic events are much less frequent than in ACS. Indeed, most studies on pre-treatment of stable CAD patients have failed to show a clear signal of benefit (10,(15)(16)(17)(18)(19)(20)(21)(22)(23) (Table 1). Consistently, the most recent guidelines issued by the…”

Section: Pre-treatment In Stable Versus Unstable Patients: Two Differmentioning

confidence: 99%

Effectiveness of Pretreatment With Dual Oral Antiplatelet Therapy

Luca

Danchin

Valgimigli³

et al. 2015

The American Journal of Cardiology

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“…Clopidogrel is an important accompanying medication in patients undergoing percutaneous coronary interventions (PCI), whereby a loading dose of 300 mg in stable coronary artery disease (at least 6-24 hours before the intervention) and 600 mg in patients with ACS (at least 2 hours before PCI), followed by a maintenance dose of 75 mg once daily, is at present recommended by international guidelines [34,35] and has been also proven in a real-world scenario [36]. Clopidogrel has been shown to be superior to ASA in patients with stable cardiovascular disease [37] and exerts in combination with ASA (dual antiplatelet therapy, DAPT) an about 20% relative risk reduction in patients with an ACS [38].…”

Section: Antiplatelet Therapymentioning

confidence: 99%

Antithrombotic therapy in patients with coronary artery disease and with type 2 diabetes mellitus

Farhan

Höchtl

Kautzky‐Willer

et al. 2010

Wien Med Wochenschr

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Diabetes mellitus (DM) is a life-threatening disease. Patients with DM have a 2- to 4-fold higher risk of developing cardiovascular disease compared to their non-diabetic counterparts. Several drugs are available for the treatment of stable coronary artery disease (CAD) and acute coronary syndrome (ACS). Among oral antiplatelet agents (acetylsalicylic acid, ticlopidine, clopidogrel, and prasugrel), prasugrel has shown the highest efficacy in patients with DM and ACS. The use of glycoprotein IIb-IIIa receptor inhibitors in diabetic subjects with ACS undergoing percutaneous coronary intervention (PCI) reduces adverse clinical events in a greater extent than in non-diabetics. Several direct and indirect antithrombins are recommended for the treatment of ACS such as unfractionated heparin (UFH), enoxaparin, fondaparinux, and bivalirudin. Enoxaparin and bivalirudin have been shown to be superior to UFH among patients with ST-elevation MI (STEMI) and non-ST elevation MI (NSTEMI) also in diabetic subgroup analyses.

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Effect of timing of clopidogrel administration on 30-day clinical outcomes: 300-mg loading dose immediately after coronary stenting versus pretreatment 6 to 24 hours before stenting in a large unselected patient cohort

Cited by 47 publications

References 26 publications

Early and Late Benefits of Prasugrel in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

Early and Late Benefits of Prasugrel in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

Effectiveness of Pretreatment With Dual Oral Antiplatelet Therapy

Antithrombotic therapy in patients with coronary artery disease and with type 2 diabetes mellitus

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