CLINICAL RESEARCH: ACUTE CORONARY SYNDROME
A Randomized Comparison of High Clopidogrel Loading Doses in Patients With NonST-Segment Elevation Acute Coronary Syndromes
The ALBION (Assessment of the Best Loading Dose of Clopidogrel to Blunt Platelet Activation, Inflammation and Ongoing Necrosis) Trial
Gilles Montalescot, MD, PhD*,1,*,
Georges Sideris, MD ,
Catherine Meuleman, MD ,
Claire Bal-dit-Sollier, MB ,1,
Nicolas Lellouche, MD||,
Ph. Gabriel Steg, MD¶,1,
Michel Slama, MD#,
Olivier Milleron, MD**,
Jean-Philippe Collet, MD, PhD*,
Patrick Henry, MD ,
Farzin Beygui, MD, PhD*,
Ludovic Drouet, MD, PhD ,1 for the ALBION Trial Investigators
* Institut de CardiologiePitié-Salpêtriére University Hospital, Assistence Publique Hôpiteux de Paris (APHP), Paris, France.
Service de CardiologieLariboisiére University Hospital, APHP, Paris, France.
Service de CardiologieSaint-Antoine University Hospital, APHP, Paris, France.
Laboratoire dHémostaseLariboisière University Hospital, APHP, Paris, France.
|| Service de CardiologieHenri-Mondor University Hospital, APHP, Paris, France.
¶ Service de CardiologieHôpital Bichat-Claude Bernard, APHP, Paris, France.
# Service de CardiologieAntoine Béclère University Hospital, APHP, Paris, France.
** Service de CardiologieAmbroise Paré University Hospital, APHP, Paris, France.
Manuscript received September 26, 2005;
revised manuscript received April 20, 2006,
accepted April 25, 2006.
* Reprint requests and correspondence to: Dr. Gilles Montalescot, Institut de Cardiologie, Bureau 2-236, Pitié-Salpêtrière Hospital, 47 Boulevard de lHôpital, 75013 Paris, France. (Email: gilles.montalescot{at}psl.aphp.fr).
OBJECTIVES: We sought to compare the antiplatelet effects of three clopidogrel loading doses (LDs).
BACKGROUND: Administration of a 300-mg clopidogrel LD is beneficial in situations requiring rapid platelet inhibition. Whether higher LDs can provide further benefits remains unknown.
METHODS: Patients (n = 103) with nonST-segment elevation acute coronary syndromes were randomized to receive a 300-mg, 600-mg, or 900-mg clopidogrel LD, given on top of other standard therapy (including acetylsalicylic acid). The main outcome measure was inhibition of adenosine diphosphate-induced inhibition of platelet aggregation (IPA); inhibition of platelet activation, inflammatory markers, troponin I release, and major adverse cardiac events also were evaluated; all measures were blindly evaluated.
RESULTS: Compared with the 300-mg LD, greater doses were associated with significantly greater platelet inhibition, with dose-effect relationships observed for onset of action, maximal plateau, 24-h areas under the curves of IPA, and rates of low IPA (<10% at 6 h), using 20 µmol/l major adverse cardiac events. A significant dose-response was also observed for the vasodilator-stimulated phosphoprotein index, a measure of P2Y12 receptor inhibition. Similar but nonsignificant trends were observed for troponin release and major adverse cardiac events. Bleeding rates were similar in each group.
CONCLUSIONS: In low-to-moderate risk patients with nonST-elevation acute coronary syndromes, clopidogrel LDs >300 mg provide a faster onset of action, a higher IPA plateau, and greater reductions in platelet activation during the first 24 h. A 900-mg LD may induce a greater antiplatelet effect than 600 mg, when compared with the standard 300-mg regimen. These findings require further clinical confirmation.
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Abbreviations and Acronyms
| | ADP = adenosine diphosphate | | ASA = acetylsalicylic acid | | AUC = area under the inhibition of platelet aggregation curve | | GP = glycoprotein | | IPA = inhibition of platelet aggregation | | LD = loading dose | | LMWH = low molecular weight heparin | | MACE = major adverse cardiac events | | MFI = median fluorescence intensity | | NSTE-ACS = nonST-segment elevation acute coronary syndrome | | PA = platelet aggregation | | PAI = plasminogen activator inhibitor | | PCI = percutaneous coronary intervention | | PGE1 = prostaglandin E1 | | sCD40L = soluble CD40 ligand | | VASP = vasodilator-stimulated phosphoprotein | | vWF Ag = von Willebrand factor antigen |
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 |
 
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 |
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|
 |

|
 |
 
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|
 |
|

|
 |

|
 |
 
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|

|
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|
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118(12):
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|
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|

|
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|
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|
 |
|

|
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|
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|
 |
|

|
 |

|
 |
 
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|
 |
|

|
 |

|
 |
 
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42(7):
989 - 1001.
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[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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Clopidogrel pre-treatment in stable angina: for all patients >6 h before elective coronary angiography or only for angiographically selected patients a few minutes before PCI? A randomized multicentre trial PRAGUE-8
Eur. Heart J.,
June 2, 2008;
29(12):
1495 - 1503.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Hjemdahl
Should we monitor platelet function during antiplatelet therapy?
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June 1, 2008;
94(6):
685 - 687.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T Geisler, M Kapp, K Gohring-Frischholz, K Daub, C Dosch, B Bigalke, H Langer, C Herdeg, and M Gawaz
Residual platelet activity is increased in clopidogrel- and ASA-treated patients with coronary stenting for acute coronary syndromes compared with stable coronary artery disease
Heart,
June 1, 2008;
94(6):
743 - 747.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. Patrono, C. Baigent, J. Hirsh, and G. Roth
Antiplatelet Drugs: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
199S - 233S.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. A. Harrington, R. C. Becker, C. P. Cannon, D. Gutterman, A. M. Lincoff, J. J. Popma, G. Steg, G. H. Guyatt, and S. G. Goodman
Antithrombotic Therapy for Non-ST-Segment Elevation Acute Coronary Syndromes: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
670S - 707S.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. G. Goodman, V. Menon, C. P. Cannon, G. Steg, E. M. Ohman, and R. A. Harrington
Acute ST-Segment Elevation Myocardial Infarction: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
708S - 775S.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J.-P. Bassand
Unmet needs in antiplatelet therapy
Eur. Heart J. Suppl.,
May 1, 2008;
10(suppl_D):
D3 - D11.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. Bonello, L. Camoin-Jau, S. Arques, C. Boyer, D. Panagides, O. Wittenberg, M.-C. Simeoni, P. Barragan, F. Dignat-George, and F. Paganelli
Adjusted Clopidogrel Loading Doses According to Vasodilator-Stimulated Phosphoprotein Phosphorylation Index Decrease Rate of Major Adverse Cardiovascular Events in Patients With Clopidogrel Resistance: A Multicenter Randomized Prospective Study
J. Am. Coll. Cardiol.,
April 8, 2008;
51(14):
1404 - 1411.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. J. Kereiakes and P. A. Gurbel
Peri-Procedural Platelet Function and Platelet Inhibition in Percutaneous Coronary Intervention
J. Am. Coll. Cardiol. Intv.,
April 1, 2008;
1(2):
111 - 121.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
V. Serebruany, V. Pasceri, G. Patti, G. Di Sciascio, F. von Lewinski, J. Riggert, W. Paulus, S. D. Wiviott, E. Braunwald, E. M. Antman, et al.
Prasugrel versus Clopidogrel
N. Engl. J. Med.,
March 20, 2008;
358(12):
1298 - 1301.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. L. L'Allier, G. Ducrocq, N. Pranno, S. Noble, R. Ibrahim, J. C. Gregoire, F. Azzari, A. Nozza, C. Berry, S. Doucet, et al.
Clopidogrel 600-mg double loading dose achieves stronger platelet inhibition than conventional regimens: results from the PREPAIR randomized study.
J. Am. Coll. Cardiol.,
March 18, 2008;
51(11):
1066 - 1072.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. J. Comerota and S. Thakur
Antiplatelet Therapy for Vascular Interventions
Perspectives in Vascular Surgery and Endovascular Therapy,
March 1, 2008;
20(1):
28 - 35.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
A. D. Michelson
P2Y12 Antagonism: Promises and Challenges
Arterioscler Thromb Vasc Biol,
March 1, 2008;
28(3):
s33 - s38.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. E. Kip, K. Hollabaugh, O. C. Marroquin, and D. O. Williams
The Problem With Composite End Points in Cardiovascular Studies The Story of Major Adverse Cardiac Events and Percutaneous Coronary Intervention.
J. Am. Coll. Cardiol.,
February 19, 2008;
51(7):
701 - 707.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. Wallentin, C. Varenhorst, S. James, D. Erlinge, O. O Braun, J. A. Jakubowski, A. Sugidachi, K. J. Winters, and A. Siegbahn
Prasugrel achieves greater and faster P2Y12receptor-mediated platelet inhibition than clopidogrel due to more efficient generation of its active metabolite in aspirin-treated patients with coronary artery disease
Eur. Heart J.,
January 1, 2008;
29(1):
21 - 30.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. Bode and K. Huber
Antiplatelet therapy in percutaneous coronary intervention
Eur. Heart J. Suppl.,
January 1, 2008;
10(suppl_A):
A13 - A20.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. F. Storey
Variability of response to antiplatelet therapy
Eur. Heart J. Suppl.,
January 1, 2008;
10(suppl_A):
A21 - A27.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. Gachet and B. Aleil
Testing antiplatelet therapy
Eur. Heart J. Suppl.,
January 1, 2008;
10(suppl_A):
A28 - A34.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. D. Wiviott, D. Trenk, A. L. Frelinger, M. O'Donoghue, F.-J. Neumann, A. D. Michelson, D. J. Angiolillo, H. Hod, G. Montalescot, D. L. Miller, et al.
Prasugrel Compared With High Loading- and Maintenance-Dose Clopidogrel in Patients With Planned Percutaneous Coronary Intervention: The Prasugrel in Comparison to Clopidogrel for Inhibition of Platelet Activation and Aggregation Thrombolysis in Myocardial Infarction 44 Trial
Circulation,
December 18, 2007;
116(25):
2923 - 2932.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. D. Wiviott, E. Braunwald, C. H. McCabe, G. Montalescot, W. Ruzyllo, S. Gottlieb, F.-J. Neumann, D. Ardissino, S. De Servi, S. A. Murphy, et al.
Prasugrel versus Clopidogrel in Patients with Acute Coronary Syndromes
N. Engl. J. Med.,
November 15, 2007;
357(20):
2001 - 2015.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. P. Giugliano and E. Braunwald
The Year in Non ST-Segment Elevation Acute Coronary Syndrome
J. Am. Coll. Cardiol.,
October 2, 2007;
50(14):
1386 - 1395.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. J. Weerakkody, J. A. Jakubowski, J. T. Brandt, C. D. Payne, H. Naganuma, and K. J. Winters
Greater Inhibition of Platelet Aggregation and Reduced Response Variability With Prasugrel Versus Clopidogrel: An Integrated Analysis
Journal of Cardiovascular Pharmacology and Therapeutics,
September 1, 2007;
12(3):
205 - 212.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
J. L. Anderson, C. D. Adams, E. M. Antman, C. R. Bridges, R. M. Califf, D. E. Casey Jr, W. E. Chavey II, F. M. Fesmire, J. S. Hochman, T. N. Levin, et al.
ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine
J. Am. Coll. Cardiol.,
August 14, 2007;
50(7):
e1 - e157.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. R. Dixon, C. L. Grines, and W. W. O'Neill
The Year in Interventional Cardiology
J. Am. Coll. Cardiol.,
July 17, 2007;
50(3):
270 - 285.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Authors/Task Force Members, J.-P. Bassand, C. W. Hamm, D. Ardissino, E. Boersma, A. Budaj, F. Fernandez-Aviles, K. A.A. Fox, D. Hasdai, E. M. Ohman, et al.
Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology
Eur. Heart J.,
July 1, 2007;
28(13):
1598 - 1660.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. A. Meadows and D. L. Bhatt
Clinical Aspects of Platelet Inhibitors and Thrombus Formation
Circ. Res.,
May 11, 2007;
100(9):
1261 - 1275.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. J. Angiolillo, A. Fernandez-Ortiz, E. Bernardo, F. Alfonso, C. Macaya, T. A. Bass, and M. A. Costa
Variability in Individual Responsiveness to Clopidogrel: Clinical Implications, Management, and Future Perspectives
J. Am. Coll. Cardiol.,
April 10, 2007;
49(14):
1505 - 1516.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. Dudek, A. Dziewierz, B. Chyrchel, L. Polonski, J. Legutko, and J. S. Dubiel
Antiplatelet treatment in non-ST-segment elevation acute coronary syndrome patients undergoing percutaneous coronary intervention (ISAR-REACT 2 insight)
Eur. Heart J. Suppl.,
February 1, 2007;
9(suppl_A):
A25 - A31.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. O'Donoghue and S. D. Wiviott
Clopidogrel Response Variability and Future Therapies: Clopidogrel: Does One Size Fit All?
Circulation,
November 28, 2006;
114(22):
e600 - e606.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
W. Hochholzer, D. Trenk, H.-P. Bestehorn, B. Fischer, C. M. Valina, M. Ferenc, M. Gick, A. Caputo, H. J. Buttner, and F.-J. Neumann
Impact of the Degree of Peri-Interventional Platelet Inhibition After Loading With Clopidogrel on Early Clinical Outcome of Elective Coronary Stent Placement
J. Am. Coll. Cardiol.,
November 7, 2006;
48(9):
1742 - 1750.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. Hirose
ICVTS on-line discussion A
Interactive CardioVascular and Thoracic Surgery,
October 1, 2006;
5(5):
636 - 636.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. R. Mehta
Clopidogrel in non-ST-segment elevation acute coronary syndromes
Eur. Heart J. Suppl.,
October 1, 2006;
8(suppl_G):
G25 - G30.
[Abstract]
[Full Text]
[PDF]
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