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

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Author(s)
Doo Sun SimMyung Ho Jeong Hyo Soo Kim Hyeon Cheol Gwon Ki Bae Seung Seung Woon Rha Shung Chull Chae Chong Jin Kim Kwang Soo Cha Jong Seon Park Jung Han Yoon Jei Keon Chae Seung Jae Joo Dong Ju Choi Seung Ho HurIn Whan Seong Myeong Chan Cho Doo Il Kim Seok Kyu Oh Tae Hoon AhnJin Yong Hwang
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean circulation journal
Issued Date
2020
Volume
50
Issue
2
Keyword
Antiplatelet agentsDrug-eluting stentsMyocardial infarction
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.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine (의과대학)
Citation
Doo Sun Sim et al. (2020). Clopidogrel versus Aspirin after Dual Antiplatelet Therapy in Acute Myocardial Infarction Patients Undergoing Drug-Eluting Stenting. Korean circulation journal, 50(2), 120–129. doi: 10.4070/kcj.2019.0166
Type
Article
ISSN
1738-5555
Source
https://e-kcj.org/DOIx.php?id=10.4070/kcj.2019.0166
DOI
10.4070/kcj.2019.0166
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43217
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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