{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T04:22:32Z","timestamp":1769314952485,"version":"3.49.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ATVB"],"published-print":{"date-parts":[[2000,10]]},"abstract":"<jats:p>\n            <jats:italic>Abstract<\/jats:italic>\n            \u2014There is a need for a rapid antithrombotic effect after the administration of antiplatelet drugs in the setting of acute coronary syndromes and percutaneous interventions. Clopidogrel, a new thienopyridine derivative, is an efficient antiplatelet agent. However, the standard regimen of clopidogrel (75 mg\/d) requires 2 to 3 days before significant antithrombotic effects. Patients with stable arterial disease on chronic aspirin therapy (n=20) were treated with clopidogrel either with a front-loaded regimen, 300 mg the first day and 75 mg\/d the next 7 days, or with a standard regimen, 75 mg\/d for 8 days. Blood thrombogenicity was assessed by quantification of platelet-thrombus formation in an ex vivo perfusion chamber, by ADP-induced platelet aggregation, and by ADP-induced fibrinogen binding. At 2 hours, mean total thrombus area with the standard regimen was not significantly reduced. In contrast, at 2 hours, the mean total thrombus area with the front-loaded regimen was significantly decreased by 23.1\u00b18.5% versus baseline (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05). ADP-induced platelet aggregation (with 5 and 10 \u03bcmol\/L) was also significantly (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05) reduced with the front-loaded regimen at 2 hours, with the mean platelet aggregation being 82.2\u00b14.4% and 81.8\u00b14.5%, respectively, versus baseline. Similarly, flow cytometry demonstrated a significant decrease (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05) in the ADP-induced fibrinogen binding (with 0.12 and 0.6 \u03bcmol\/L) at 2 hours in this front-loaded regimen group (36.1\u00b12.0% and 53.2\u00b19.3%). With the standard regimen, platelet activity was not significantly reduced at 2 hours. Our data suggest that a front-loaded regimen of clopidogrel added to aspirin achieves a significant antithrombotic effect at 2 hours in patients with known atherosclerotic disease on chronic aspirin therapy. This provides a rationale for using front-loaded clopidogrel in combination with aspirin in percutaneous coronary interventions.\n          <\/jats:p>","DOI":"10.1161\/01.atv.20.10.2316","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T19:44:19Z","timestamp":1308339859000},"page":"2316-2321","source":"Crossref","is-referenced-by-count":65,"title":["Acute Antithrombotic Effect of a Front-Loaded Regimen of Clopidogrel in Patients With Atherosclerosis on Aspirin"],"prefix":"10.1161","volume":"20","author":[{"given":"Ge\u0301rard","family":"Helft","sequence":"first","affiliation":[{"name":"From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio I.","family":"Osende","sequence":"additional","affiliation":[{"name":"From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen G.","family":"Worthley","sequence":"additional","affiliation":[{"name":"From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azfar G.","family":"Zaman","sequence":"additional","affiliation":[{"name":"From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oswaldo J.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli I.","family":"Lev","sequence":"additional","affiliation":[{"name":"From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E.","family":"Farkouh","sequence":"additional","affiliation":[{"name":"From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentin","family":"Fuster","sequence":"additional","affiliation":[{"name":"From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan J.","family":"Badimon","sequence":"additional","affiliation":[{"name":"From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James H.","family":"Chesebro","sequence":"additional","affiliation":[{"name":"From the Zena and Michael A. 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