Clopidogrel versus Aspirin after Dual Antiplatelet Therapy in Acute Myocardial Infarction Patients Undergoing Drug-Eluting Stenting

Authors
Doo Sun SimMyung Ho JeongHyo Soo KimHyeon Cheol GwonKi Bae SeungSeung Woon RhaShung Chull ChaeChong Jin KimKwang Soo ChaJong Seon ParkJung Han YoonJei Keon ChaeSeung Jae JooDong Ju ChoiSeung Ho HurIn Whan SeongMyeong Chan ChoDoo Il KimSeok Kyu OhTae Hoon AhnJin Yong Hwang
Department
Dept. of Internal Medicine (내과학)
Issue Date
2020
Citation
Korean Circulation Journal, Vol.50(2) : 120-129, 2020
ISSN
1738-5555
Abstract
Background and Objectives: There is a paucity of data regarding the benefit of clopidogrel monotherapy after dual antiplatelet therapy (DAPT) in patients treated with drug-eluting stents (DES). This study compared outcome between clopidogrel versus aspirin as monotherapy after DES for acute myocardial infarction (MI). Methods: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 1,819 patients treated with DES who were switched to monotherapy with clopidogrel (n=534) or aspirin (n=1,285) after uneventful 12-month DAPT were analyzed. The primary endpoint was net adverse clinical events (NACE), defined as a composite of death from any cause, MI, repeat percutaneous coronary intervention (PCI), stent thrombosis, ischemic stroke, or major bleeding during the period from 12 to 24 months. Results: After adjustment using inverse probability of treatment weighting, patients who received clopidogrel, compared with those treated with aspirin, had a similar incidence of NACE (0.7% and 0.7%; hazard ratio, 1.06; 95% confidence interval, 0.31–3.60; p=0.923). The 2 groups had similar rates of death from any cause (0.1% in each group, p=0.789), MI (0.3% and 0.1%, respectively; p=0.226), repeat PCI (0.1% and 0.3%, respectively; p=0.548), stent thrombosis (0.1% and 0%, respectively; p=0.121), major bleeding (0.2% in each group, p=0.974), and major adverse cardiovascular and cerebrovascular events (0.5% in each group, p=0.924). Conclusions: Monotherapy with clopidogrel, compared to aspirin, after DAPT showed similar clinical outcomes in patients with acute MI treated with DES.
Keywords
Antiplatelet agentsDrug-eluting stentsMyocardial infarction
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/42553
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
Keimyung Author(s)
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Full Text
https://e-kcj.org/search.php?where=aview&id=10.4070/kcj.2019.0166&code=0054KCJ&vmode=FULL
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