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A Randomized Comparison of High Clopidogrel Loading Doses in Patients With Non–ST-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^_*,_*, Georges Sideris, MD, Catherine Meuleman, MD, Claire Bal-dit-Sollier, MB, Nicolas Lellouche, MD^||, Ph. Gabriel Steg, MD^¶, Michel Slama, MD^#, Olivier Milleron, MD^_**, Jean-Philippe Collet, MD, PhD^_*, Patrick Henry, MD, Farzin Beygui, MD, PhD^_*, Ludovic Drouet, MD, PhD for the ALBION Trial Investigators

^_* Institut de Cardiologie–Pitié-Salpêtriére University Hospital, Assistence Publique Hôpiteux de Paris (APHP)
Service de Cardiologie–Lariboisiére University Hospital, APHP
Service de Cardiologie–Saint-Antoine University Hospital, APHP
Laboratoire d'Hémostase–Lariboisière University Hospital, APHP
^|| Service de Cardiologie–Henri-Mondor University Hospital, APHP
^¶ Service de Cardiologie–Hôpital Bichat-Claude Bernard, APHP
^# Service de Cardiologie–Antoine Béclère University Hospital, APHP
^_** Service de Cardiologie–Ambroise Paré University Hospital, APHP, Paris, France

View larger version (24K): [in a new window]   Figure 1 (A) Percentage inhibition of platelet aggregation after stimulation with 5 µmol/l adenosine diphosphate (ADP). (B) Percentage inhibition of platelet aggregation after stimulation with 20 µmol/l ADP.

View larger version (26K): [in a new window]   Figure 2 Areas under the curves for inhibition of adenosine diphosphate (ADP)-induced platelet aggregation between 0 and 24 h. Error bars indicate standard deviations of the mean. AUC = area under the IPA curve.

View larger version (25K): [in a new window]   Figure 3 (Left) Mean fluorescence intensity (MFI) after the coadministration of PGE1 and adenosine diphosphate (ADP) at 6 h after dosing. (Right) Vasodilator-stimulated phosphoprotein (VASP) index at 6 h after dosing. Error bars indicate standard deviations of the mean.

View larger version (32K): [in a new window]   Figure 4 Proportion of patients with increased troponin over the course of 24 h.