Assessing the efficacy and safety of low dose clopidogrel in Chinese ACS patients undergoing PCI: A retrospective study

Continuation of single antiplatelet treatment (SAPT) is recommended for patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) after dual antiplatelet treatment (DAPT). However, the optimal long-term SAPT remains unclear for these patients. The retrospective study recruited ACS patients who underwent PCI and chosen clopidogrel to SAPT after DAPT between 01/2014 and 12/2016 at the Central Hospital of Wuhan, Wuhan, China. Patients were divided into 2 groups after standard DAPT: low dose group (clopidogrel, 50 mg/d) and control group (clopidogrel, 75 mg/d). Among 378 enrolled patients with ACS undergoing PCI, 49/378 (14.5%) were taking 50 mg clopidogrel after DAPT. At the mean follow-up of 34 months, the cumulative incidence of the primary outcomes (hazard ratio [HR] 1.345, 95% CI: 0.455-3.974; P = .592), secondary outcome (HR 1.483, 95% CI: 0.506-4.348; P = .473), and safety outcomes (HR 2.268, 95% CI: 0.835-6.160; P = .108) showed no significant differences between the 2 group. Propensity score-matched analysis confirmed these findings. A 50 mg maintenance dose of clopidogrel may be comparable to 75 mg clopidogrel for Chinese patients with ACS undergoing PCI after at least 12 months of DAPT in efficacy and safety.