Key result
A single 75-mg dose of clopidogrel before carotid endarterectomy reduced platelet response to ADP compared to placebo (67.16% vs 77.32%; P=0.01), an effect negatively correlated with patient weight.
Why the study?
Does a single 75-mg dose of clopidogrel reduce platelet activation in patients on long-term aspirin undergoing carotid endarterectomy?
Population
n=56 patients on long-term aspirin (150 mg) undergoing carotid endarterectomy
Comparison
Clopidogrel 75 mg single tablet taken before… vs Placebo taken before carotid endarterectomy
Design
RCT, randomized
Follow-up
at the end of surgery
Authors
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Supports pre-CEA clopidogrel in aspirin-treated patients; extends RCT evidence for additive ADP inhibition before carotid surgery.
RCT (n=56)
randomized
Does a single 75-mg dose of clopidogrel reduce platelet activation in patients on long-term aspirin undergoing carotid endarterectomy?
Absolute Event Rate: 67.16% vs 77.32%
p-value: p=0.01
A single 75-mg dose of clopidogrel before carotid endarterectomy significantly reduces platelet activation and ADP response, providing a mechanistic explanation for its clinical impact on embolization.
Payne et al. (2007) conducted an RCT in Patients undergoing carotid surgery (n=56). Clopidogrel vs. Placebo was evaluated on Percentage of platelets binding fibrinogen in response to 10(-6)M ADP before surgery (p=0.01). A single 75-mg dose of clopidogrel before carotid endarterectomy reduced platelet response to ADP compared to placebo (67.16% vs 77.32%; P=0.01), an effect negatively correlated with patient weight.
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