Related Experiment Video

Updated: Aug 2, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Increased mortality after coronary stenting in patients treated with clopidogrel without loading dose. Evidence from

G G L Biondi-Zoccai1, P Agostoni, L Testa

  • 1Institute of Cardiology, Caholic University, Rome, Italy. gbiondizoccai@tiscali.it

Minerva Cardioangiologica
|June 15, 2004
PubMed

Insights

Clopidogrel with a loading dose is as effective as ticlopidine after coronary stenting. However, clopidogrel without a loading dose significantly increases the risk of death or myocardial infarction.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Clopidogrel is an alternative to ticlopidine post-coronary stenting, valued for hematologic safety.
  • Debate exists regarding clopidogrel's efficacy compared to ticlopidine.

Purpose of the Study:

  • To systematically review randomized trials comparing clopidogrel versus ticlopidine after coronary stenting.
  • To evaluate the comparative efficacy and safety of clopidogrel and ticlopidine in patients undergoing coronary stenting.

Main Methods:

  • Systematic review and meta-analysis of five randomized trials (2,962 patients).
  • Searched multiple databases including Medline, BioMed Central, and Current Contents (1986-2003).
  • Computed fixed-effect relative risks for mortality, with subgroup analyses based on clopidogrel loading dose regimens.

Main Results:

  • Overall, a non-significant trend towards increased mortality with clopidogrel (2.3%) versus ticlopidine (1.7%) was observed.
  • Clopidogrel with a loading dose showed non-significantly lower mortality (0.9%) compared to ticlopidine (1.6%).
  • Clopidogrel without a loading dose was associated with a significantly higher risk of death (4.2%) compared to ticlopidine (1.7%).

Conclusions:

  • Clopidogrel with a loading regimen appears equivalent or superior to ticlopidine post-coronary stenting.
  • Clopidogrel therapy without a loading dose is linked to a significantly increased risk of death or myocardial infarction.
Abstract

More Related Videos

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

Related Concept Videos

Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...