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RESEARCH ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 1  |  Page : 3

Changes of high sensitivity C-reactive protein during clopidogrel therapy in patients undergoing percutaneous coronary intervention


1 Department of Cardiology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, IR Iran
2 Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
3 Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
4 Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Michigan State University, Sparrow Health System, East Lansing, Michigan, USA

Correspondence Address:
Mitra Chitsazan
Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran
IR Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.5812/cardiovascmed.30091

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Background: The crucial role of inflammation in the development and progression of atherosclerosis has been previously described. However, there is insufficient data available to demonstrate the changes in high sensitivity C-reactive protein (hs-CRP) during clopidogrel therapy. Objectives: In the present study, we aimed to assess the changes in the inflammatory marker of coronary heart disease, i.e., hs-CRP during clopidogrel therapy, in patients undergoing percutaneous coronary intervention (PCI). We also evaluated the anti-inflammatory effects of clopidogrel, if any, in different groups of patients. Patients and Methods: The study population included 650 consecutive patients who underwent elective, urgent, or emergent PCI. Patients received a300-mg loading dose of clopidogrel (Plavix®) and aspirin either 24 hours before the planned PCI, or immediately before the procedure in patients with urgent or emergent PCI, followed by a 75-mg daily maintenance dose for up to 12 weeks. At the end of the 12th week, hs-CRP was re-assessed. Results: Six hundred-fifty patients including 386 (59.4%) male and 264 (40.6%) female subjects were enrolled in the study. The mean hs- CRP level was 15.36 ± 9.83 mg/L with a median of 14 mg/L (interquartile range 8 to 19.6 mg/L). Female, hypertensive, diabetic, and non- smoking patients had higher reductions in hs-CRP in response to clopidogrel therapy compared to male, non-hypertensive, non-diabetic and smoker patients, respectively (all P < 0.005). The changes in the hs-CRP levels were also statistically different in patients with various index events before PCI (P < 0.001). No significant differences were observed in the mean reduction of hs-CRP between the patients without stent implantation and those with bare metal or drug-eluting stents (P = 0.07), respectively. Conclusions: We found that the use of clopidogrel in patients undergoing PCI had favorable effects on the suppression of hs-CRP. This effect appears to be heightened and more apparent in some group of patients with co-morbidities such as diabetes and hypertension.


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