Clopidogrel Efficacy and Acute Coronary Syndromes

Charles University, Czech Republic40 enrolled

Overview

The purpose of this study is to compare clopidogrel effectiveness between severe hemodynamically unstable versus stable patients with acute myocardial infarction.

Clopidogrel exists in oral form only. As a prodrug, it has to be metabolized to the active form by cytochrome system in the liver. Both facts could lead to lower efficacy of the drug in hemodynamically unstable patients, where splanchnic and liver hypoperfusion is present. We hypothesised that clopidogrel efficacy is insufficient in patients with acute myocardial infarction and severe hemodynamic instability. Therefore we would like to compare the effect of clopidogrel in unstable STEMI patients on mechanical ventilation with stable STEMI patients.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Acute Myocardial Infarction

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria for unstable group: * acute STEMI * mechanical ventilation * the need for catecholamine support. Inclusion Criteria for stable group: * acute myocardial infarction Exclusion Criteria for any: * previous treatment with clopidogrel * clopidogrel administration during transport by ambulance * known intolerance to clopidogrel * history of thrombocytopenia (\<150,000 platelets/ml) * pre-existing liver disease

Locations (1)

Cardiocenter, 3rd Medical School, Charles University and University Hospital Kralovske Vinohrady

Prague, Czechia

Outcomes

Primary Outcomes

Lower efficacy of clopidogrel determined by VASP measurement

Time frame: 6 months

Secondary Outcomes

Higher frequency of stent thrombosis in the unstable group

Time frame: 6 months

Data from ClinicalTrials.gov

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