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Clopidogrel Loading Dose 300 vs. 600 mg in Patients Undergoing One-Stop Hybrid Coronary Revascularization: A

Yulin Guo1, Dongjie Li1, Yingdi Gao1

  • 1Department of Cardiac Surgery, Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Frontiers in Surgery
|November 1, 2021
PubMed

Insights

The 600 mg clopidogrel loading dose is safe for one-stop hybrid coronary revascularization (HCR), showing no increase in major bleeding events compared to the 300 mg dose. Further research is needed to confirm benefits.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Optimal clopidogrel loading dose for one-stop hybrid coronary revascularization (HCR) is not established.
  • This study addresses the
  • evidence-free
  • zone regarding clopidogrel dosing in HCR.

Purpose of the Study:

  • To compare major bleeding and ischemic thrombotic events with two clopidogrel loading doses (300 mg vs. 600 mg) in patients undergoing one-stop HCR.
  • To evaluate the safety and efficacy of different clopidogrel loading regimens in this specific patient population.

Main Methods:

  • Prospective, single-center, randomized pilot study.
  • 100 patients undergoing one-stop HCR were randomized to receive either 300 mg or 600 mg of clopidogrel loading dose.
  • Evaluation of major bleeding (BARC, PLATO) and composite ischemic thrombotic events post-procedure.

Main Results:

  • Postoperative chest drainage volumes were comparable between the 300 mg and 600 mg clopidogrel groups.
  • No significant differences in Bleeding Academic Research Consortium (BARC) or PLATelet inhibition and patient Outcomes (PLATO) major bleeding events were observed.
  • Composite ischemic thrombotic and adverse events were similar between the two clopidogrel loading dose groups.

Conclusions:

  • A 600 mg clopidogrel loading dose does not appear to increase major bleeding events compared to 300 mg in patients undergoing one-stop HCR.
  • Further investigation with larger sample sizes is required to fully ascertain the potential benefits of the 600 mg loading dose in one-stop HCR.

Keywords:
clopidogrelheart surgeryhybrid coronary revascularization (HCR)major bleedingpilot study

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