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Impact of Clopidogrel Loading Dose in Patients With Chronic Kidney Disease Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

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Author(s)
Joon Young KimMyung Ho JeongJae Hyun MoonYong Keun AhnShung Chull ChaeSeung Ho HurTaek Jong HongYoung Jo KimIn Whan SeongIn Ho ChaeMyeong Chan ChoYang Soo JangJung Han YoonKi Bae SeungSeung Jung Park
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
American Journal of Cardiology
Issued Date
2012
Volume
110
Issue
11
Abstract
The optimal loading dose of clopidogrel in patients with chronic kidney disease who
undergo primary percutaneous coronary intervention for ST-segment elevation myocardial
infarction has not been investigated. The aim of this study was to assess the impact of
clopidogrel loading dose on clinical outcomes in this setting. A total of 1,457 patients with
CKD (estimated glomerular filtration rate <60 ml/min/1.73 m2) were evaluated according
to clopidogrel loading dose: 600 mg (n 861) versus 300 mg (n 596). In-hospital
complications, including major bleeding and clinical outcomes at 1 and 12 months, were
compared between the 2 groups. The in-hospital major bleeding rate was similar (0.8% vs
0.2%, p 0.09). Also, there were no differences in major adverse cardiac event rates,
including death, recurrent myocardial infarction, target lesion revascularization, and stent
thrombosis, at 1 month (15.6% vs 16.4%, p 0.70) and 12 months (19.0% vs 21.3%, p
0.32). On multivariate analysis, a 600-mg loading dose of clopidogrel was not an independent
predictor of 1-month (odds ratio 1.13, 95% confidence interval 0.49 to 2.57, p 0.78)
and 12-month (odds ratio 0.89, 95% confidence interval 0.52 to 1.51, p 0.66) major
adverse cardiac events. After propensity score–matched analysis, these results were unchanged.
In conclusion, a 600-mg loading dose of clopidogrel was not effective in reducing
1- and 12-month major adverse cardiac events in patients with chronic kidney disease who
underwent primary percutaneous coronary intervention for ST-segment elevation myocardial
infarction, but this dose did not increase the in-hospital major bleeding rate. © 2012
Elsevier Inc. All rights reserved. (Am J Cardiol 2012;110:1598 –1606)
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine
Citation
Joon Young Kim et al. (2012). Impact of Clopidogrel Loading Dose in Patients With Chronic Kidney Disease Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction. American Journal of Cardiology, 110(11), 1598–1606. doi: 10.1016/j.amjcard.2012.07.025
Type
Article
ISSN
0002-9149
Source
https://linkinghub.elsevier.com/retrieve/pii/S0002914912018462
DOI
10.1016/j.amjcard.2012.07.025
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34891
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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