To the Editor We read with interest the meta-analysis by Siller-Matula et al , which reported that intensified clopidogrel loading with 600 mg reduces the rate of major cardiovascular events without increase in major bleeding compared with 300 mg in patients undergoing percutaneous coronary intervention (PCI) during 1-month follow-up.1 A large body of evidence has suggested the …

Loading and maintenance dose of aspirin, maintenance dose of clopidogrel or any P2Y 12 inhibitor, arterial access and sheath management, as well as the choice of periprocedural anticoagulant (unfractionated heparin, bivalirudin, low-molecular-weight heparin, or fondaparinux) were left to the discretion of the investigators with respect to local standard practices. The combination of aspirin and clopidogrel represents the treatment of choice to prevent stent thrombosis early after coronary stenting (CS). Circulation 2000;101:2823-8. Background— It is not known whether further suppression of platelet function can be achieved with clopidogrel beyond that provided by currently recommended loading and maintenance doses.

For most patients, however, a downside to using a 600-mg loading dose of clopidogrel and waiting at least 2 hours before PCI is hard to detect in the present data. In patients who need an antiplatelet effect within hours, initiate Plavix with a single 300 mg oral loading dose and then continue at 75 mg once daily.

Initiating Plavix without a loading dose will delay establishment of an antiplatelet effect by several days [see Clinical Pharmacology (12.3) and …

Clopidogrel is available under the following different brand names: Plavix. Early potent antithrombotic effect with combined aspirin and a loading dose of clopidogrel on experimental arterial thrombogenesis in humans. A number of studies have evaluated clinical outcomes with a 600 mg clopidogrel loading dose in patients undergoing PCI, 5,6,12–14 but only two of these studies have compared the outcomes between the standard 300 mg loading dose with the higher dose. Methods .

1 Clopidogrel has a better safety profile and a more accelerated antiplatelet activity than ticlopidine using a standard 300 mg oral loading dose (LD). The safety of clopidogrel loading has been extensively investigated in patients with minor strokes and transient ischemic attacks. Objective .

To study the safety and efficacy of a clopidogrel loading dose in patients with moderate and severe acute ischemic strokes. † Stop cangrelor 1 to 6 hours prior to scheduled procedure; may restart oral therapy 1 to 6 hours post-procedure; Clopidogrel is recommended oral therapy for restarting, regardless of previous P2Y 12 inhibitor used For clinicians practicing in cardiac and other settings, reading this new consensus document will provide a wealth of information about switching between P2Y 12 inhibitors. Loading dose 300 mg, to be taken prior to the procedure, alternatively loading dose 600 mg, higher dose may produce a greater and more rapid inhibition of platelet aggregation. Of the 3101 people screened, 87.2% did not meet inclusion criteria. Clopidogrel oral tablet is a prescription medication used to prevent heart attack or stroke. Starting treatment without a loading dose will delay effects by several days. Compared with high clopidogrel loading dose group, patients with low loading dose were more likely to suffer from Killip class >1.

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