PMID- 19604542
OWN - NLM
STAT- MEDLINE
DCOM- 20100702
LR  - 20181201
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 125
IP  - 4
DP  - 2010 Apr
TI  - A randomised study comparing the antiplatelet and antiinflammatory effect of 
      clopidogrel 150 mg/day versus 75 mg/day in patients with ST-segment elevation 
      acute myocardial infarction and poor responsiveness to clopidogrel: results from 
      the DOUBLE study.
PG  - 309-14
LID - 10.1016/j.thromres.2009.06.016 [doi]
AB  - INTRODUCTION: The antiplatelet effect of standard or increased clopidogrel doses 
      in patients with ST- segment elevation acute myocardial infarction (STEMI) has 
      never been studied. In this study we compared the antiplatelet effect of a 75 mg 
      daily maintenance dose of clopidogrel with 150 mg in patients with STEMI 
      undergoing primary percutaneous coronary intervention (PCI). MATERIALS AND 
      METHODS: Fifty-four patients with STEMI undergoing PCI were randomly allocated to 
      receive either 75 mg/day clopidogrel (group 1) or 150 mg/day (group 2) for 1 
      month. Platelet function, measured by 5 different assays, was determined at 3 
      time points: 38+/-8 hours after the procedure, 1 week and 1 month after 
      randomization. RESULTS: In group 1, mean +/- SD platelet reactivity index (PRI) 
      measured with the VASP assay was 57.7+/-15.7% and 46.9+/-15.7% at 1 week and 1 
      month, respectively, compared to 38.8+/-15.7% and 34.9+/-12.6% in group 2 
      (p=0.0001). Same results were observed for light transmittance aggregometry, 
      whole blood aggregometry and VerifyNow, but not for thromboelastometry. In 
      contrast to what may be expected, the 75 mg daily maintenance dose took longer 
      than 1-week to provide the full clopidogrel antiplatelet effect. Furthermore, 
      patients in group 2 had a nearly 50% reduction in C-reactive protein levels both 
      at 1 week and 1 month. CONCLUSION: In patients with STEMI and poor responsiveness 
      to clopidogrel a 150 mg daily maintenance dose of clopidogrel is associated with 
      a significant reduction of platelet aggregation and a trend towards reduced 
      inflammation.
CI  - (c) 2009 Elsevier Ltd. All rights reserved.
FAU - Palmerini, Tullio
AU  - Palmerini T
AD  - Istituto di Cardiologia, Policlinico S. Orsola, Universita di Bologna, Italy. 
      tulliopalmerini@hotmail.com
FAU - Barozzi, Chiara
AU  - Barozzi C
FAU - Tomasi, Luciana
AU  - Tomasi L
FAU - Sangiorgi, Diego
AU  - Sangiorgi D
FAU - Marzocchi, Antonio
AU  - Marzocchi A
FAU - De Servi, Stefano
AU  - De Servi S
FAU - Ortolani, Paolo
AU  - Ortolani P
FAU - Reggiani, Letizia Bacchi
AU  - Reggiani LB
FAU - Alessi, Laura
AU  - Alessi L
FAU - Lauria, Giulia
AU  - Lauria G
FAU - Bassi, Mirna
AU  - Bassi M
FAU - Branzi, Angelo
AU  - Branzi A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20090714
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Cell Adhesion Molecules)
RN  - 0 (Microfilament Proteins)
RN  - 0 (Phosphoproteins)
RN  - 0 (vasodilator-stimulated phosphoprotein)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
MH  - Anterior Wall Myocardial Infarction
MH  - Anti-Inflammatory Agents/pharmacology/*therapeutic use
MH  - C-Reactive Protein/pharmacology/therapeutic use
MH  - Cell Adhesion Molecules/metabolism
MH  - Clopidogrel
MH  - Humans
MH  - Microfilament Proteins/metabolism
MH  - Myocardial Infarction/blood/*drug therapy
MH  - Phosphoproteins/metabolism
MH  - Platelet Aggregation/*drug effects
MH  - Ticlopidine/*analogs & derivatives/pharmacology/therapeutic use
EDAT- 2009/07/17 09:00
MHDA- 2010/07/03 06:00
CRDT- 2009/07/17 09:00
PHST- 2009/04/02 00:00 [received]
PHST- 2009/06/17 00:00 [revised]
PHST- 2009/06/19 00:00 [accepted]
PHST- 2009/07/17 09:00 [entrez]
PHST- 2009/07/17 09:00 [pubmed]
PHST- 2010/07/03 06:00 [medline]
AID - S0049-3848(09)00301-6 [pii]
AID - 10.1016/j.thromres.2009.06.016 [doi]
PST - ppublish
SO  - Thromb Res. 2010 Apr;125(4):309-14. doi: 10.1016/j.thromres.2009.06.016. Epub 
      2009 Jul 14.