Clopidogrel High Dose Evaluation for the Patient With Coronary Artery Disease in Japan

Dual antiplatelet therapy of aspirin and thienopyridine is used to prevent stent thrombosis after percutaneous coronary intervention (PCI). Clopidogrel is the most popular thienopyridine. Following the 300mg clopidogrel loading dose (LD) at first day, patients take 75mg maintenance dose (MD) to inhibit platelet aggregation after coronary stent implantation. 600mg high LD inhibit platelet aggregation more rapidly and strongly than standard LD and prevent thrombotic event around the PCI. Similarly high MD inhibit platelet aggregation more strongly. Interindividual variability of clopidogrel anti-platelet effect has been reported. In Japanese, there are many non or hyporesponders to clopidogrel compared to the Western population. The purpose of this study is to evaluate the effect of high dose clopidogrel as the antiplatelet therapy on inhibition of platelet aggregation in Japanese patients scheduled for PCI due to ischemic heart disease.

Inclusion criteria

• Patients scheduled for percutaneous coronary intervention due to ischemic heart disease
• Patients taking aspirin 81-100mg at least 1 week.

Exclusion criteria

• Patients with ST elevation myocardial infarction
• Patients have contraindication of aspirin or clopidogrel
• Patients taking warfarin
• Patients received thrombolytic therapy within 2 weeks
• Patients taking anti-platelet agents except aspirin within 1 month
• Patients taking corticosteroid.
• Patients taking proton pump inhibitor