Researchers found that giving patients at least 600mg of Bristol-Myers Squibb’s Plavix (clopidogrel) before the procedure, rather than the standard 300mg dose, halved the risk of major complications associated with blood clotting, or thrombosis. In addition, the higher dose did not increase the risk of serious bleeding.
Clopidogrel interferes with the action of platelet cells, which stimulate the formation of blood clots. Interventional cardiologists give patients a loading dose of this medication before percutaneous coronary intervention (PCI) to protect against blood clotting. After the procedure, most patients take a lower daily dose (75mg) for up to a year, depending on the type of stent used to prop open the clogged coronary artery.
Overall, pretreatment with high-dose clopidogrel (600mg or more) was associated with a 50% reduction in the risk of cardiac death or nonfatal heart attack, both during the initial hospitalization and within 30 days of the PCI procedure, while there was no statistically significant increase in major or minor bleeding.