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To the Editor: Despite of the absence of benefit associated with clopidogrel pretreatment at 28 days, Dr Steinhubl and colleagues¹ drew attention to a trend in favor of benefit among those who received clopidogrel loading 6 to 24 hours prior to PCI. Patients who received clopidogrel pretreatment within 6 hours prior to PCI did not experience any benefit. While it is biologically plausible that a longer pretreatment interval might be necessary, this observation would be rendered more credible if a relationship could be demonstrated between pretreatment interval and magnitude of benefit. Although such a supplementary analysis might be underpowered, the results may be informative nonetheless.

Brian Y. L. Wong, MD; Eric A. Cohen, MD
Sunnybrook and Women's College Health Sciences Center
Toronto, Ontario

1. Steinhubl SR, Berger PB, Mann JT 3rd, Fry ET, DeLago A, Wilmer C, Topol EJ. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA. 2002;288:2411-2420. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289:1926.

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