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In-Lab Clopidogrel as Effective as Pre-Loading Before PCI

No significant difference between two options in terms of major adverse cardiac events

TUESDAY, Aug. 3 (HealthDay News) -- Giving clopidogrel after coronary angiography but before percutaneous coronary intervention (PCI) appears to be as effective as pre-loading the drug four to eight hours before PCI, according to research published in the Aug. 10 issue of the Journal of the American College of Cardiology.

Germano Di Sciascio, M.D., of the Campus Bio-Medico University of Rome, and colleagues conducted a randomized trial of the efficacy of giving 600 mg clopidogrel in the cardiac catheterization lab after angiography but before PCI (in-lab) versus the efficacy of giving it in the standard way, four to eight hours pre-procedure (pre-load). The primary end point was the 30-day incidence of a major adverse cardiac event.

The researchers found no significant difference in primary end point between the in-lab (8.8 percent) and pre-load (10.3 percent) groups at 30 days (P = 0.72). The incidence of bleeding or vascular complications did not significantly differ between the two groups (5.4 versus 7.8 percent; P = 0.42). Platelet reactivity was higher during PCI and two hours post-intervention in the in-lab group than in the pre-load group (P ≤ 0.043).

"When indicated, in-lab clopidogrel administration can be a safe alternative to routine pretreatment given before knowing patients' coronary anatomy," the authors conclude.

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