Key result
Early clopidogrel loading before PCI shows no benefit over late loading for major events.
Why the study?
The impact of timing of clopidogrel loading dose administration before or after the start of PCI on periprocedural complications including bleeding remains debated.
Does early clopidogrel loading dose compared to late loading dose reduce periprocedural complications in patients undergoing PCI without P2Y12 inhibitor pretreatment?
RCT (n=5,438)
double-blind
randomized
Does early clopidogrel loading dose compared to late loading dose reduce periprocedural complications in patients undergoing PCI without P2Y12 inhibitor pretreatment?
In patients undergoing PCI without P2Y12 inhibitor pretreatment, administering the clopidogrel loading dose before versus after the start of PCI resulted in similar rates of periprocedural complications and bleeding.
Early loading was associated with similar periprocedural outcomes; leaves open optimal timing pending randomized data.
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Abtan et al. (2019) conducted an RCT in Patients requiring percutaneous coronary intervention (n=5,438). Early clopidogrel loading dose (before start of PCI) vs. Late clopidogrel loading dose (after start of PCI) was evaluated on death, myocardial infarction, ischemia-driven revascularization, or stent thrombosis (OR 1.11, 95% CI 0.87-1.41, p=0.41). Early clopidogrel loading before PCI resulted in similar rates of death, MI, ischemia-driven revascularization, or stent thrombosis compared to late loading (OR 1.11; 95% CI 0.87-1.41; P=0.41).
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