Effect of different dose of clopidogrel evaluated by thrombelastography in aged patients with acute coronary syndrome

Objective:To evaluate antiplatelet effect of different doses of clopidogrel using thrombelastography(TEG) in aged patients with acute coronary syndrome(ACS) not undergoing revascularization.Methods:A total of 60 aged ACS patients not undergoing revascularization were randomly divided into group A [n=30,received clopidogrel 75 mg/d for maintenance after coronary angiography(CAG)] and group B(n=30,received clopidogrel 50 mg/d for maintenance after CAG).Both groups received clopidogrel 300 mg before CAG.Liver and renal function and platelet inhibition rate measured by TEG were measured in two groups within 24h before CAG and one week after CAG.Major adverse cardiovascular events and adverse reactions were observed in two groups within three months after CAG.Results:Compared with before treatment,there were significant increase in ADP induced platelet inhibition rate [group A:(25.8±11.4)% vs.(75.2±12.3)%,group B:(24.2±13.3)% vs.(64.8±17.5)%] and arachidonic acid(AA)induced platelet inhibition rate [group A:(16.7±21.6)% vs.(82.7±25.4)%,group B:(23.8±22.2)% vs.(80.2±22.7)%,P0.05] in two groups one week after treatment,and there were no significant difference between two groups(P0.05).There were no significant difference in incidence rate of MACE and adverse reaction within three months between two groups(P0.05).Conclusion:Low dose clopidogrel is also effective in aged patients with acute coronary syndrome not undergoing revascularization.