Antiplatelet effect of 50-mg maintenance dose of clopidogrel compared to 200 mg ticlopidine: a preliminary study

• Published in: Heart and vessels Vol. 25; no. 1; pp. 41 - 44
• Main Authors: Fukushima, Kenichi, Kobayashi, Yoshio, Kitahara, Hideki, Iwata, Yo, Kuroda, Nakabumi, Ooyama, Masayuki, Kuwabara, Yoichi, Nomura, Fumio, Komuro, Issei
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 2010; Springer Nature B.V
• Subjects: Adenosine Diphosphate; Aged; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Asian Continental Ancestry Group; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Coronary Artery Disease - blood; Coronary Artery Disease - ethnology; Coronary Artery Disease - therapy; Coronary vessels; Dose-Response Relationship, Drug; Drug dosages; Drug therapy; Female; Humans; Japan; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pilot Projects; Platelet Aggregation - drug effects; Platelet Aggregation Inhibitors - administration & dosage; Stents; Thrombosis - blood; Thrombosis - etiology; Thrombosis - prevention & control; Ticlopidine - administration & dosage; Ticlopidine - analogs & derivatives; Time Factors; Treatment Outcome; Vascular Surgery; Japan; Antiplatelet therapy; Stent; Stent thrombosis
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-009-1165-y

In the United States and Europe, patients with coronary stents are maintained on 75 mg clopidogrel. Because the maintenance dose of ticlopidine in patients with coronary stents is 100 mg twice daily in Japan and 250 mg twice daily in the United States and Europe, in Japanese patients a lower dose of clopidogrel may achieve an antiplatelet effect comparable to 200 mg ticlopidine. Platelet aggregation was evaluated in 104 consecutive patients on 50 mg clopidogrel plus aspirin ( n = 54) and 200 mg ticlopidine plus aspirin ( n = 50). Platelets were stimulated with adenosine diphosphate (5 and 20 μmol/l) and aggregation was assessed by optical aggregometry. There was no significant difference in platelet aggregation induced with 5 (37% ± 11% vs 38% ± 15%, not significant) and 20 μmol/l adenosine diphosphate (48% ± 13% vs 51% ± 12%, not significant) between 50 mg clopidogrel and 200 mg ticlopidine. In Japanese patients, there is the possibility that a maintenance dose of 50 mg clopidogrel on platelet inhibition is comparable to 200 mg ticlopidine.