Efficacy and safety of different maintenance doses of clopidogrel for patients after percutaneous coronary intervention：a systematic review

Abstract:

Objective：To assess the efficacy and safety of different maintenance doses of clopidogrel for patients after percutaneous coronary intervention（PCI） by a meta-analysis and to provide some advices for clinical therapy. Methods：According to the methods of evidence-based medicine，randomized controlled trials（RCTs） about the different maintenance doses of clopidogrel using on pa－tients after PCI were searched. Data were extracted into a designed form and the quality of selected articles was analyzed. The Rev Man 5.0 software was used for data analysis. Results：Thirteen RCTs containing 2 883 patients were included. The meta-analysis showed that 150 mg clopidogrel significantly inhibited platelet aggregation（PA） and reduced major adverse cardiac events（MACE） incidence than 75 mg clopidogrel（MD=-12.20，95%CI=-13.77 to -10.63，P=0.000）（RR=0.41，95%CI=0.27 to 0.63，P=0.000）. Finally，No obvious difference was found in major bleeding（RR=1.61，95%CI=0.90 to 2.87，P=0.110） or minor bleeding（RR=1.19，95%CI=0.87 to 1.62，P=0.270） between the two groups. Conclusion：Clopidogrel with dose of 150 mg is superior to clopidogrel with dose of 75 mg in inhibiting PA and reducing MACE for patients after PCI without bleeding risk.