Fukushima Kenichi, Kobayashi Yoshio, Kitahara Hideki, Iwata Yo, Kuroda Nakabumi, Ooyama Masayuki, Kuwabara Yoichi, Nomura Fumio, Komuro Issei
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Heart Vessels. 2010 Jan;25(1):41-4. doi: 10.1007/s00380-009-1165-y. Epub 2010 Jan 21.
In the United States and Europe, patients with coronary stents are maintained on 75 mg clopidogrel. Because the maintenance dose of ticlopidine in patients with coronary stents is 100 mg twice daily in Japan and 250 mg twice daily in the United States and Europe, in Japanese patients a lower dose of clopidogrel may achieve an antiplatelet effect comparable to 200 mg ticlopidine. Platelet aggregation was evaluated in 104 consecutive patients on 50 mg clopidogrel plus aspirin (n = 54) and 200 mg ticlopidine plus aspirin (n = 50). Platelets were stimulated with adenosine diphosphate (5 and 20 mumol/l) and aggregation was assessed by optical aggregometry. There was no significant difference in platelet aggregation induced with 5 (37% +/- 11% vs 38% +/- 15%, not significant) and 20 mumol/l adenosine diphosphate (48% +/- 13% vs 51% +/- 12%, not significant) between 50 mg clopidogrel and 200 mg ticlopidine. In Japanese patients, there is the possibility that a maintenance dose of 50 mg clopidogrel on platelet inhibition is comparable to 200 mg ticlopidine.
在美国和欧洲，冠状动脉支架植入患者服用氯吡格雷的维持剂量为75毫克。由于在日本冠状动脉支架植入患者中噻氯匹定的维持剂量为每日两次，每次100毫克，而在美国和欧洲为每日两次，每次250毫克，因此对于日本患者，较低剂量的氯吡格雷可能会产生与200毫克噻氯匹定相当的抗血小板作用。对104例连续服用50毫克氯吡格雷加阿司匹林（n = 54）和200毫克噻氯匹定加阿司匹林（n = 50）的患者进行了血小板聚集评估。用二磷酸腺苷（5和20微摩尔/升）刺激血小板，并通过光学聚集法评估聚集情况。50毫克氯吡格雷组和200毫克噻氯匹定组在5微摩尔/升（37%±11%对38%±15%，无显著差异）和20微摩尔/升二磷酸腺苷刺激下的血小板聚集（48%±13%对51%±12%，无显著差异）无显著差异。对于日本患者，50毫克氯吡格雷的维持剂量对血小板抑制作用可能与200毫克噻氯匹定相当。
