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|Title: ||Impact of Double Loading Regimen of Clopidogrel on FinalAngiographic Results, Incidence of Upper Gastrointestinal Bleeding and ClinicalOutcomes in Patients with STEMI Undergoing Primary Coronary Intervention.|
|Authors: ||鄭銘燊;Tong, Meng-Shen;宋沛勳;Sung, Pei-Hsun;柳居豐;Liu, Chu-Feng;陳冠宏;Chen, Kuan-Hung;鍾昇穎;Chung, Sheng-Ying;蔡慧玲;Chua, Sarah;Ch, Chien-Jen;Chen, Chien-Jen;李威杰;Lee, Wei-Chieh;柴漢東;Chai, Han-Tan;葉漢根;Yip, Hon-Kan;Ch, Hsueh-Wen;Chang, Hsueh-Wen|
|Issue Date: ||2018-04-03 09:51:09 (UTC+8)|
|Abstract: ||This study tested the therapeutic impact of double-loading dose (i.e., 600 mg) versus standard-loading dose
(i.e., 300 mg) of clopidogrel on ST-segment-elevation-myocardial-infarction (STEMI) patients undergoing
Between January 2005 and December 2013, a total of 1461 STEMI patients undergoing PCI were consecutively
enrolled into the study and categorized into group 1 (600 mg/clopidogrel; n = 508) and group 2 (300 mg/
clopidogrel; n = 953). We assessed angiographic thrombolysis-in-myocardial-infarction (TIMI) flow in the
infarct-related-artery, 30-day mortality and upper-gastrointestinal-bleeding (UGIB) within 30 days as primaryendpoints
and later incidents of UGIB as secondary-endpoints.
The results showed that the incidences of advanced Killip score (defined as score 3) upon presentation
(23.8% versus 24.6%) and advanced heart failure (defined as NYHAFc-3) (10.2% versus 10.4%) did not differ
between groups 1 and 2 (all P > 0.4). Primary-endpoints, which were final TIM-3 flow (91.3% versus
91.7%) in the infarct-related-artery, incidences of 30-day mortality (5.8% vs. 7.1%), and UGIB 30 day (7.8%
versus 8.9%) did not differ between group 1 and group 2 (all P > 0.33). The secondary-endpoints which were
incidences of 30-day < one-year (5.2% versus 4.7) and > one-year (8.9% versus 10.1%) UGIB did not differ
between groups 1 and 2 (all P > 0.45). One-year mortality did not differ between two groups (10.74% versus
12.9%) (P > 0.25). Multiple-stepwise-logistic-regression analysis showed that age and advanced-Killip score
were independently predictive of 30-day mortality (all P < 0.001).
Double-loading dose of clopidogrel did not confer an additional benefit to the final angiograph results, 30-
day/one-year clinical outcomes; and age and advanced Killip-score were powerful predictors of 30-day mortality.
|Relation: ||International Heart Journal|
|Appears in Collections:||[護理學系] 期刊論文|
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