Comparison of clopidogrel versus ticlopidine for prevention of minor myocardial injury after elective coronary stenting.

We searched a randomized, double-blinded, prospective study that compared the effectiveness of clopidogrel versus ticlopidine for prevention of minor myocardial injury (MMI) and major clinical events (MCEs) after elective coronary stenting. A total of 158 consecutive patients (98 male, 60 female patients with a mean age of 59.3+/-5.4 years) were divided into two arms based on treatment with thienopyridines: group I, clopidogrel 1 x 300 mg as a loading dose, and 1 x 75 mg per day thereafter, group II, ticlopidine 2 x 250 mg daily. Both thienopyridines were started on the same day as stent placement. Cardiac troponin T (cTnT) was measured immediately before and 12 h after the procedures. All patients were followed-up during the hospital stay (6+/-2 days) with respect to MMI and MCEs. The increase frequency and the amount of cTnT level in group I was found significantly lower compared with group II (5 vs.15; P<0.01; 0.38+/-0.11 vs. 0.44+/-0.12 ng/ml; P<0.001, respectively). Patients with elevated cTnT levels more likely to have C type lesion (P<0.004). Though there was a trend toward increased major clinical events rate in group II than those of group I, the statistical difference was not different (4 vs. 1.3%; P>0.05). The present study showed that the combination of clopidogrel and aspirin was more effective than the combination of ticlopidine and aspirin in decreasing the rate of MMI.