doi: 10.1161/CIRCULATIONAHA.108.190526
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(Circulation. 2008;118:1217-1218.)
© 2008 American Heart Association, Inc.
Clinical Summaries
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Dose Effect of Clopidogrel Reloading in Patients Already on 75-mg Maintenance Dose: The Reload With Clopidogrel Before Coronary Angioplasty in Subjects Treated Long Term With Dual Antiplatelet Therapy (RELOAD) Study |
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The findings of the RELOAD study have relevant implications for clinicians with regard to dosing issues of clopidogrel in patients on a maintenance dose of 75 mg who are candidates for an elective percutaneous coronary intervention. It was only recently shown that a loading dose
600 mg may reduce hard events within the first months of percutaneous coronary intervention in clopidogrel-naïve patients, suggesting that poor response to clopidogrel was a modifiable risk factor in the setting of percutaneous coronary intervention. In addition, clopidogrel at the approved maintenance dose of 75 mg has been shown to achieve a modest antiplatelet effect, and up to one third of patients may continue to have elevated platelet reactivity. The RELOAD study supports the clinical use of a high clopidogrel loading dose of 900 mg in patients undergoing percutaneous coronary intervention even when patients already receive long-term therapy of clopidogrel. In the clopidogrel-treated patients of the RELOAD study, a single administration of 900-mg loading dose was the only independent correlate of an optimal light transmission aggregation response compared with 300- or 600-mg loading. This regimen was associated with a dramatic reduction in poor response, regardless of the definition used, within 4 hours of administration. The results of RELOAD are consistent with those of other recent studies supporting the use of a high loading dose of clopidogrel. See p 1225.
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Hot Flashes and Subclinical Cardiovascular Disease: Findings From the Study of Women’s Health Across the Nation Heart Study |
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The present study found impaired flow-mediated dilation and higher aortic calcification among women at midlife reporting menopausal hot flashes. Hot flashes, common during the menopausal
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