Efficacy and safety of low-dose clopidogrel in Japanese patients after drug-eluting stent implantation: a randomized pilot trial

• Published in: Heart and vessels Vol. 29; no. 1; pp. 1 - 6
• Main Authors: Ohkubo, Kenji, Fujimoto, Yoshihide, Iwata, Yo, Kitahara, Hideki, Kadohira, Tadayuki, Sugimoto, Kazumasa, Morino, Tomoki, Kobayashi, Yoshio
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.01.2014; Springer Nature B.V
• Subjects: Aged; Asian Continental Ancestry Group; Aspirin - administration & dosage; Biomedical Engineering and Bioengineering; Blood clots; Cardiac Surgery; Cardiology; Cardiovascular disease; Clinical outcomes; Clinical trials; Coronary Artery Disease - diagnosis; Coronary Artery Disease - ethnology; Coronary Artery Disease - therapy; Coronary Thrombosis - etiology; Coronary Thrombosis - prevention & control; Drug therapy; Drug Therapy, Combination; Drug-Eluting Stents; Female; Humans; Japan - epidemiology; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Infarction - etiology; Myocardial Infarction - prevention & control; Original Article; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Pilot Projects; Platelet Aggregation Inhibitors - administration & dosage; Platelet Aggregation Inhibitors - adverse effects; Prospective Studies; Risk Factors; Stents; Ticlopidine - administration & dosage; Ticlopidine - adverse effects; Ticlopidine - analogs & derivatives; Time Factors; Treatment Outcome; Ultrasonography, Interventional; Vascular Surgery; Japan; Antiplatelet therapy; Stent; Stent thrombosis
• ISSN: 0910-8327; 1615-2573; 1615-2573
• DOI: 10.1007/s00380-012-0318-6

In Japan, a lower maintenance dose of ticlopidine is used than in the United States and Europe. Therefore a lower maintenance dose of clopidogrel may also be considered appropriate in Japanese patients. The present randomized pilot study evaluated the efficacy and safety of 50 mg clopidogrel in Japanese patients who underwent drug-eluting stent (DES) implantation. A total of 200 patients with 277 lesions who underwent intravascular ultrasound-guided DES implantation were enrolled. The subjects were allocated to the 50- or 75-mg clopidogrel group. All patients received 100 mg aspirin daily before the procedure, and this continued indefinitely. The duration of clinical follow-up was 21.8 ± 5.7 months in the 75-mg group and 21.9 ± 6.1 months in the 50-mg group ( P = 0.96). During follow-up, no cardiac death, myocardial infarction, or stent thrombosis was observed in either group. Side effects of clopidogrel were observed in 4 patients (4.0 %) in the 75-mg group and in 4 patients (4.0 %) in the 50-mg group. Following this randomized pilot study, it may be justified to perform a large-scale randomized study comparing 50- and 75-mg dosing of clopidogrel in Japanese patients undergoing coronary stent implantation.