Article Text
Abstract
Objective To assess the beneficial efficacy and safety of the high maintenance dose of clopidogrel in acute anterior myocardial infarction (AMI) patients undergoing selective percutaneous coronary intervention (PCI).
Methods 25 patients were enrolled into this study. These cases were randomly divided into the high maintenance dose group (n=26, 14 males, 150 mg clopidogrel per day) and the control group (n=26, 15 males, 75 mg clopidogrel per day). QCA and TIMI Myocardial perfusion grading (TMPG) were used to analyse the lesion and reperfusion of the culprit vessel and myocardium. Record the information of patients in-hospital, in the 1 month and 6 months including the level of BNP, left ventricular ejection fraction (LVEF), the left ventricular peak ejection rate (LPER), the left ventricular peak filling rate (LPFR), the left ventricular time to peak ejection rate (LTPER) and left ventricular time to peak filling rate (LTPFR).
Result 1. The CTFC of the high maintenance dose group after PCI was smaller than the standard dose groupThe percentage of TMPG 3 grade was higher in the high maintenance dose group 2. The left ventricular peak ejection rate (LPER), the left peak filling rate (LPFR) 6 months after PCI in the high maintenance dose group was higher than the control group. The left ventricular time to peak ejection rate (LTPER), left ventricular time to peak filling rate (LTPFR) 1 month after PCI in the high maintenance were lower than the control group. 3. There were less acute and subacute thrombosis cases in the high maintenance dose group than the standard dose group. There was no significant difference in haemorrhage events between two groups.
Conclusion The high maintenance dose clopidogrel can improve cardiac function. There is potential benefit in increasing coronary blood flow and improving myocardium perfusion. High maintenance dose clopidogrel decreases the acute and subacute thrombosis but do not increase the haemorrhage events.