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Clopidogrel Reloading in Clopidogrel Resistant Patients With ACS

This study has been completed.
Information provided by:
Sheba Medical Center Identifier:
First received: March 6, 2007
Last updated: September 19, 2007
Last verified: September 2007
Laboratory clopidogrel resistance is associated with adverse atherothrombotic events in patients with coronary artery disease. In the proposed study we wish to prospectively assess the effect of reloading with 600 mg clopidogrel, and administer maintenance treatment with clopidogrel 150 mg/day for one month in a group of acute myocardial infarction (AMI) patients who demonstrate non-responsiveness to clopidogrel.

Condition Intervention Phase
Clopidogrel Non-Responsiveness Drug: clopidogrel Phase 3

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Clopidogrel Reloading in Clopidogrel Resistant Patients With ACS

Resource links provided by NLM:

Further study details as provided by Sheba Medical Center:

Primary Outcome Measures:
  • Platelet reactivity

Secondary Outcome Measures:
  • recurrent ACS
  • stroke
  • death

Estimated Enrollment: 50
Study Start Date: March 2005
Study Completion Date: June 2007
Detailed Description:
Prior studies have demonstrated significant variability in platelet response to clopidogrel in patients with coronary artery disease (CAD). Up to 25% of patients have been shown to be non-responders to a conventional dose of clopidogrel. This phenomenon has been associated with higher incidence of recurrent cardiovascular (CVS) adverse events in patients with acute coronary syndrome (ACS), and higher incidence of peri-procedural myocardial damage, thrombotic complications, and ischemic events in patients undergoing elective percutaneous coronary intervention (PCI). Both the ex-vivo anti-platelet effect and the clinical benefit of clopidogrel are dose related. Moreover, in patients sustaining ACS while on maintenance clopidogrel treatment, reloading with 600 mg clopidogrel, resulted in further reduction in platelet aggregation, although the patients were not non-responders. Despite this, the effect of dose escalation has never been examined in patients resistant to clopidogrel. In the present study we wish to assess prospectively the effect of reloading with 600 mg clopidogrel, and double dose maintenance treatment (150 mg/day) for one month in acute myocardial infarction (AMI) patients who demonstrate non-respondese to clopidogrel.

Ages Eligible for Study:   18 Years to 80 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • age equal or over 18 years
  • acute coronary syndrome
  • Clopidogrel non-responsive
  • signed an informed consent

Exclusion Criteria:

  • Bleeding disorder
  • hypersensitivity to aspirin or clopidogrel
  • any contraindication to anti-thrombotic or anticoagulant therapy
  • active neoplastic disorder
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Please refer to this study by its identifier: NCT00444132

ICCU, Sheba Medical Center
Tel-hashomer, Ramat Gan, Israel
Sponsors and Collaborators
Sheba Medical Center
Principal Investigator: Shlomi Matetzky, MD Senior Physician, ICCU, Sheba Medical Center.
  More Information Identifier: NCT00444132     History of Changes
Other Study ID Numbers: SHEBA-05-3621-SM-CTIL
Study First Received: March 6, 2007
Last Updated: September 19, 2007

Keywords provided by Sheba Medical Center:
acute coronary syndrome
percutaneous coronary intervention

Additional relevant MeSH terms:
Platelet Aggregation Inhibitors
Purinergic P2Y Receptor Antagonists
Purinergic P2 Receptor Antagonists
Purinergic Antagonists
Purinergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Fibrinolytic Agents
Fibrin Modulating Agents
Cytochrome P-450 CYP2C19 Inhibitors
Cytochrome P-450 Enzyme Inhibitors
Enzyme Inhibitors processed this record on July 21, 2017