Investigation Of Discontinuation Methods Of Clopidogrel After Percutaneous Coronary Intervention In Patients With Acute Coronary Syndromes

Objectives:1.To investigate the appropriate methods of administration and discontinuation of clopidogrel in patients with acute coronary syndromes after percutaneous coronary intervention(PCI).2.To evalute the interaction of asprin and clopidogrel to low down the inflammation level.3.To comprehend the molecular biology mechanisms of the anti-inflammation role of antiplatelet drugs.Methods:To execute the project,we adopt the method of case-case study.89 patients with acute coronary syndromes,who received PCI and standard medical therapy after admission,were divided into two groups.After discharge from hospital,the patients in group A(n=52)received clopidogrel at 75mg/d for 12 months,and then stopped this drug;the patients in group B(n=37)firstly received clopidogrel at 75mg/d for 12 months,and then took 37.5mg/d for 2 weeks.We measured the levels of high sensitive C reaction protein(hs-CRP)and solute CD40 ligand(sCD40L)of the patients at the end of 12 months after receiving clopidogrel and 2 weeks after discontinuation or decrease.Results: Compared with group A,the levels of hs-CRP and sCD40L in group B had no significantly differences at the end of 12 months;however,they were higher after further 2 weeks(group A,P＜0.05;group B,p＞0.05).and they were significantly higher in group A than those in group B(P＜0.01).Conclusions:1.The administration of Clopidogrel plus aspirin for a long term can decrease the serum inflammation level.2.Decrease of the dose of Clopidogrel gradually is better than discontinuation immediately to low down the inflammation level.3.The antiplatelet drugs play a role of anti-inflammation in ACS patients which by a complex progress and passways of cytokins.