A Randomized Open Blind Control Study Assessing Clopidogrel Resistance in Iranian Patients Undergoing Percutaneous Coronary Intervention in Rajaie Heart Center

The prevalence of response variability to clopidogrel in Iranian patients undergoing elective percutaneous coronary intervention (PCI) with stenting, impleta has not been fully investigated. We evaluated clopidogrel antiplatelet effects of 300 mg versus a 450 mg in open blind randomized clinical trial in a referral teaching hospital in Iran. Methods Fifty patients scheduled for elective PCI were enrolled. One group received 300 mg and the other one received 450 mg before PCI procedure. Platelet aggregation analyzed by optical aggregometery at baseline and after loading dose prior to PCI.Results The ratios of responders (IPA ≥30%), hypo-responders (10%≤IPA<30%), and nonresponders(IPA <10%) were 36%, 42%, and 22%, respectively. Significantly more patients achieved 95% IPA with the high-dose tirofiban regimen.Conclusions It can be concluded that 450mg of clopidogrel had approximately 35% and 300 mg ofclopidogrel had 20% reduction in ADP-induced platelet aggregation, although therewas still a broad inter-individual variation by increasing dose.