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Optimal Duration of Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation A Randomized, Controlled Trial

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Author(s)
Cheol Whan LeeJung-Min AhnDuk-Woo ParkSoo-Jin KangSeung-Whan LeeYoung-Hak KimSeong-Wook ParkSeungbong HanSang-Gon LeeIn-Whan SeongSeung-Woon RhaMyung-Ho JeongDo-Sun LimJung-Han YoonSeung-Ho HurYun-Seok ChoiJoo-Young YangNae-Hee LeeHyun-Sook KimBong-Ki LeeKee-Sik KimSeung-Uk LeeJei-Keon ChaeSang-Sig CheongIl-woo SuhHun-Sik ParkDeuk-Young NahDoo-Soo JeonKi-Bae SeungKeun LeeJae-Sik JangSeung-Jung Park
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Circulation
Issued Date
2014
Volume
129
Issue
3
Abstract
Background—The risks and benefits of long-term dual antiplatelet therapy remain unclear.

Methods and Results—This is a prospective, multicenter, open-label, randomized comparison trial that was conducted in 24 clinical centers in Korea. In total, 5045 patients who received drug-eluting stents and were free of major adverse cardiovascular events and major bleeding for at least 12 months after stent placement were enrolled between July 2007 and July 2011. Patients were randomized to receive aspirin alone (n=2514) or clopidogrel plus aspirin (n=2531). The primary end point was a composite of death from cardiac causes, myocardial infarction, or stroke 24 months after randomization. At 24 months, the primary end point occurred in 57 aspirin-alone group patients (2.4%) and 61 dual-therapy group patients (2.6%) (hazard ratio, 0.94; 95% confidence intervals [CI], 0.66 to 1.35; P=0.75). The two groups did not differ significantly in terms of the individual risks of death from any cause, myocardial infarction, stent thrombosis, or stroke. Major bleeding occurred in 24 (1.1%) and 34 (1.4%) of the aspirin-alone group and dual-therapy group patients, respectively (hazard ratio, 0.71; 95% CI, 0.42 to 1.20; P=0.20).

Conclusions—Among patients who were on 12-month dual antiplatelet therapy without complications, an additional 24 months of dual antiplatelet therapy versus aspirin alone did not reduce the risk of the composite end point of death from cardiac causes, myocardial infarction or stroke.

Clinical Trial Registration Information—http://www.clinicaltrials.gov. Identifier: NCT01186146.
Key Words: stent
aspirin
clopidogrel
coronary
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine
Citation
Cheol Whan Lee et al. (2014). Optimal Duration of Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation A Randomized, Controlled Trial. Circulation, 129(3), 304–312. doi: 10.1161/CIRCULATIONAHA.113.003303
Type
Article
ISSN
0009-7322
DOI
10.1161/CIRCULATIONAHA.113.003303
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35418
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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