scholarly journals Clopidogrel Induced Haematological Dyscrasia: A Case Report

1970 ◽  
Vol 5 (2) ◽  
pp. 89-90
Author(s):  
Abdul Wadud Chowdhury ◽  
Amanullah Bin Siddiq ◽  
AEM Masharul Islam ◽  
Amitav Saha
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Blood Count ◽  
Complete Blood Count ◽  
Coronary Intervention ◽  
Arterial Disease ◽  
Coronary Syndrome ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Peripheral Arterial

Clopidogrel is an analogue of ticlopidine, used for reduction of atherosclerotic events in patients with acute coronary syndrome (ACS), stroke, peripheral arterial disease and for elective percutaneous coronary intervention (PCI). It selectively and irreversibly blocks ADP binding to platelets. Its primary side effect is bleeding. However potentially fatal types of haematological dyscrasia such as aplastic anaemia, neutropenia, thrombocytopenia, pancytopenia may be associated with clopidogrel therapy. A 50 years old diabetic, hypertensive lady with angina was started to treat with clopidogrel along with other anti-ischaemic and anti-hypertensive drugs. Subsequently the patient developed leucopenia and thrombocytopenia after starting of clopidogrel. Five days later her complete blood count returned to normal after withdrawal of both anti platelets. Aspirin was re-introduced with great precaution. Later repeat leucocyte and platelet count were found to be normal. At follow- up 1 month after discharge patient found asymptomatic with normal blood count. To the best of our knowledge, clopidogrel induced haematological dyscrasia was not reported earlier in our country. Key words: Acute coronary syndrome; percutaneous coronary intervention. DOI: 10.3329/uhj.v5i2.4563 University Heart Journal Vol.5(2) July 2009 pp.89-90

Loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome

Perfusion ◽  
2020 ◽  
pp. 026765912092785
Author(s):  
Ya-Ru Zhang ◽  
Zheng-Kai Xue ◽  
Kang-Yin Chen ◽  
Ling-Xia Xu ◽  
Wei-Ding Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Odds Ratio ◽  
Coronary Intervention ◽  
Coronary Syndrome ◽  
Elective Percutaneous Coronary Intervention ◽  
Asian Patients ◽  
Percutaneous Coronary ◽  
Periprocedural Myocardial Infarction

Background: Periprocedural myocardial infarction is a common complication following percutaneous coronary intervention. The present study was conducted with an aim to compare the safety and efficacy of loading doses of ticagrelor versus clopidogrel in preventing periprocedural myocardial infarction in Asian patients with acute coronary syndrome undergoing elective percutaneous coronary intervention. Methods: A total of 114 patients with acute coronary syndrome undergoing elective percutaneous coronary intervention were assigned to clopidogrel group (n = 57, the loading and maintenance doses were 300 and 75 mg qd for clopidogrel, and 300 and 100 mg qd for aspirin), or ticagrelor group (n = 57, the loading and maintenance doses were 180 and 90 mg bid for ticagrelor, and 300 and 100 mg qd for aspirin). Cardiac biomarkers were measured before, 8 hours, and 24 hours after percutaneous coronary intervention. The percutaneous coronary intervention–related periprocedural myocardial infarction was defined according to the fourth universal definition of myocardial infarction (2018). Results: The overall incidence of percutaneous coronary intervention–related periprocedural myocardial infarction was 21.1%. The ticagrelor group showed a significantly lower incidence of periprocedural myocardial infarction (12.3% vs 29.8%, p = 0.022) and numerically lower bleeding events (3.5% vs 8.8%, p = 0.242) as compared with clopidogrel group. No patient had major adverse cardiovascular events during the 1-month follow-up. The levels of high-sensitivity C-reactive protein did not differ significantly between the two groups (p > 0.05), indicating that the benefits of ticagrelor were not from its anti-inflammatory effects. Multivariable analysis showed that the use of ticagrelor (odds ratio: 0.50; 95% confidence interval: 0.29-0.87; p = 0.014) and number of stents (odds ratio: 2.75; 95% confidence interval: 1.25-6.06; p = 0.012) were independent predictors of periprocedural myocardial infarction. Conclusion: Pretreatment with a loading dose of ticagrelor seems to be superior in reducing the incidence of percutaneous coronary intervention–related periprocedural myocardial infarction in Asian patients with acute coronary syndrome as compared with clopidogrel.

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