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Five hundred and three patients on >10 days clopidogrel therapy (41% with non-ST-segment elevation acute coronary syndrome, ACS) randomly received 600 mg clopidogrel loading 4-8 h before PCI (n = 252) or placebo (n = 251). Primary endpoint was 30-day incidence of major adverse cardiac events (MACE). In the overall population primary endpoint occurred in % of patients in the reload vs. % in the placebo arm [odds ratios (OR) , 95% confidence intervals (CI) -; P = ]. In stable angina patients, 1-month MACE were not significantly different ( vs. %; OR , -; P = ), whereas ACS patients had significant clinical benefit with reloading ( vs. %; OR , 95% CI -, P = at multivariable analysis; interaction test: P = ). There was no excess bleeding in the reload arm (6% in both groups).
Impaired DNA repair mechanisms may contribute to earlier depletion of the ovarian reserve during aging.  As women age, double-strand breaks accumulate in the DNA of their primordial follicles. Primordial follicles are immature primary oocytes surrounded by a single layer of granulosa cells. An enzyme system is present in oocytes that ordinarily accurately repairs DNA double-strand breaks. This repair system is called " homologous recombinational repair", and it is especially effective during meiosis. Meiosis is the general process by which germ cells are formed in all sexual eukaryotes; it appears to be an adaptation for efficiently removing damages in germ line DNA.  (See Meiosis .)