Assessing the efficacy and safety of low dose clopidogrel in Chinese ACS patients undergoing PCI: A retrospective study

评估低剂量氯吡格雷治疗中国急性冠脉综合征(ACS)患者行经皮冠状动脉介入治疗(PCI)的疗效和安全性:一项回顾性研究

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Abstract

Continuation of single antiplatelet treatment (SAPT) is recommended for patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) after dual antiplatelet treatment (DAPT). However, the optimal long-term SAPT remains unclear for these patients. The retrospective study recruited ACS patients who underwent PCI and chosen clopidogrel to SAPT after DAPT between 01/2014 and 12/2016 at the Central Hospital of Wuhan, Wuhan, China. Patients were divided into 2 groups after standard DAPT: low dose group (clopidogrel, 50 mg/d) and control group (clopidogrel, 75 mg/d). Among 378 enrolled patients with ACS undergoing PCI, 49/378 (14.5%) were taking 50 mg clopidogrel after DAPT. At the mean follow-up of 34 months, the cumulative incidence of the primary outcomes (hazard ratio [HR] 1.345, 95% CI: 0.455-3.974; P = .592), secondary outcome (HR 1.483, 95% CI: 0.506-4.348; P = .473), and safety outcomes (HR 2.268, 95% CI: 0.835-6.160; P = .108) showed no significant differences between the 2 group. Propensity score-matched analysis confirmed these findings. A 50 mg maintenance dose of clopidogrel may be comparable to 75 mg clopidogrel for Chinese patients with ACS undergoing PCI after at least 12 months of DAPT in efficacy and safety.

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