I’ve always wondered this before; some people use 300mg of clopidogrel, some use 600mg, and various references and guidelines say to use either. But surely there’s an actual right answer?
Indeed there is. This randomised controlled trial from JACC looked at just over 201 patients, randomised to either 300mg or 600mg of clopidogrel to patients with a STEMI prior to PCI.
CK-MB and troponin were significantly less with the higher dose group, MACE rates were less, and despite the higher dose, bleeding complications weren’t higher. Angiographic outcomes were also improved.
So, use the 600mg dose for now – the question remains as to whether this actually affects mortality…
Check it out here.