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J Am Coll Cardiol, 2008; 51:1066-1072, doi:10.1016/j.jacc.2007.12.013
© 2008 by the American College of Cardiology Foundation
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Clopidogrel 600-Mg Double Loading Dose Achieves Stronger Platelet Inhibition Than Conventional Regimens

Results From the PREPAIR Randomized Study

Philippe L. L’Allier, MD*, Grégory Ducrocq, MD, Nicolas Pranno, MD, Stéphane Noble, MD, Reda Ibrahim, MD, Jean C. Grégoire, MD, Fabian Azzari, MD, Anna Nozza, MSc, Colin Berry, MD, PhD, Serge Doucet, MD, Benoit Labarthe, PharmD, Pierre Théroux, MD, Jean-Claude Tardif, MD for the PREPAIR Study Investigators

Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.


Figure 1
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  		Figure 1 Percent Inhibition of Peak Aggregation

Group A, clopidogrel 300 mg the day before (≥15 h) + 75 mg the morning of the interventional procedure; Group B, clopidogrel 600 mg the morning of (≥2 h before) the interventional procedure; Group C, clopidogrel 600 mg the day before (≥15 h) and 600 mg the morning of (≥2 h before) the interventional procedure. Significant differences between Groups A versus C and Groups B versus C were found for 5 µmol/l and 20 µmol/l adenosine diphosphate (ADP) (see text for details).

 

Figure 2
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  		Figure 2 Percent Inhibition of Late Aggregation

Late platelet aggregation: 6 min after the addition of the agonist. Group A, clopidogrel 300 mg the day before (≥15 h) + 75 mg the morning of the interventional procedure; Group B, clopidogrel 600 mg the morning of (≥2 h before) the interventional procedure; Group C, clopidogrel 600 mg the day before (≥15 h) and 600 mg the morning of (≥2 h before) the interventional procedure. Significant differences between Groups A versus C and Groups B versus C were found for both for 5 and 20 µmol/l adenosine diphosphate (ADP) (see text for details).

 

Figure 3
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  		Figure 3 Clopidogrel Resistance

Data presented according to 3 definitions of resistance: <10%, <20%, and <40% decrease in peak platelet aggregation. (A) 5 µmol/l ADP; (B) 20 µmol/l ADP. Group A, clopidogrel 300 mg the day before (≥15 h) + 75 mg the morning of the interventional procedure; Group B, clopidogrel 600 mg the morning of (≥2 h before) the interventional procedure; Group C, clopidogrel 600 mg the day before (≥15 h) and 600 mg the morning of (≥2 h before) the interventional procedure. Significant differences between Groups A versus C and Groups B versus C were found for 5 µmol/l and 20 µmol/l adenosine diphosphate (see text for details).

 
 
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