Efficacy of Adjusted Clopidogrel Dose in Patients With Insufficient Platelet Inhibition
|ClinicalTrials.gov Identifier: NCT00302913|
Recruitment Status : Completed
First Posted : March 15, 2006
Last Update Posted : July 4, 2006
|Condition or disease||Intervention/treatment|
|Coronary Artery Disease Drug Resistance||Drug: Adjustment of clopidogrel dose|
Background: The EXCELSIOR trial demonstrated a 7-fold increased risk for death, myocardial infarction and target vessel reintervention within 30 days in patients with platelet inhibition below median of study cohort after a bolus dose of 600 mg of clopidogrel. The median of platelet inhibition in this cohort was 14 % optical aggregation after stimulation with 5 µM ADP.
Aim: To evaluate the efficacy of clopidogrel dose adjustment in patients with insufficient platelet inhibition after elective coronary stent implantation
Methods: This prospective, single-center study will evaluate antiplatelet effects in 120 patients receiving a bolus dose of 600 mg of clopidogrel before undergoing elective coronary stent implantation. Platelet inhibition will be evaluated 24 hours, 14 and 28 days after coronary intervention using optical aggregometry (5 µM ADP) and determination of surface protein expression by flow cytometry (P-Selectin, gp55, activated GP IIb/IIIa). If 24 hours after coronary stent implantation optical aggregation is >14 %, patients will receive an additional bolus dose of 300 mg of clopidogrel, followed by a daily dose of 150 mg for at least 28 days. If optical aggregation at this point of time is ≤14 % patients will receive a daily dose of 75 mg of clopidogrel. No further dose adjustments during follow up will be performed.
Hypothesis: Adjustment of clopidogrel dose in patients with insufficient platelet inhibition determined by optical aggregometry will provide a comparable antiplatelet effect as in patients with sufficient platelet inhibition after coronary stent implantation.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||120 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Official Title:||Efficacy of Adjusted Clopidogrel Dose in Patients With Insufficient Platelet Inhibition After Elective Coronary Stenting|
|Study Start Date :||December 2005|
|Estimated Study Completion Date :||June 2006|
- Antiplatelet effect after fourteen and twenty-eight days determined by optical aggregometry after stimulation with ADP
- Antiplatelet effect after fourteen and twenty-eight days determined by flow cytometric evaluation of surface protein expression after stimulation with ADP
- Major cardiac events within thirty days (death, myocardial infarction, target vessel reintervention)
- Bleeding and vascular access site complications within thirty days
- Drug-drug interaction of clopidogrel with concomitant treatment
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00302913
|Heart Center Bad Krozingen,|
|Bad Krozingen, Germany, 79189|
|Study Director:||Franz-Josef Neumann, MD||Heart Center Bad Krozingen, Germany|