Extended Clopidogrel Therapy Beyond 12 Months and Long-Term Outcomes in Patients With Diabetes Mellitus Receiving Coronary Arterial Second-Generation Drug-Eluting Stents
- Authors
- Cho, Sung Woo; Park, Kyutae; Ahn, Jong-Hwa; Park, Taek Kyu; Lee, Su Yeon; Kim, Jihoon; Lee, Joo Myung; Yang, Jeong Hoon; Song, Young Bin; Choi, Jin-Ho; Choi, Seung-Hyuk; Gwon, Hyeon-Cheol; Lee, Sang Hoon; Ahn, Joonghyun; Carriere, K. C.; Hahn, Joo-Yong
- Issue Date
- 1-Sep-2018
- Publisher
- EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
- Citation
- AMERICAN JOURNAL OF CARDIOLOGY, v.122, no.5, pp.705 - 711
- Indexed
- SCIE
SCOPUS
- Journal Title
- AMERICAN JOURNAL OF CARDIOLOGY
- Volume
- 122
- Number
- 5
- Start Page
- 705
- End Page
- 711
- URI
- https://scholarworks.bwise.kr/gnu/handle/sw.gnu/11275
- DOI
- 10.1016/j.amjcard.2018.05.001
- ISSN
- 0002-9149
- Abstract
- We investigated the associations between extended clopidogrel therapy and long-term clinical outcomes in patients with diabetes mellitus (DM) after second-generation drug eluting stent (DES) implantation. Landmark analysis was performed in 1,600 patients who received second-generation DES and were event-free at 12 months after the index procedure. The primary outcome was a composite of all-cause death or nonfatal myocardial infarction (MI) at 5 years after the index procedure. After inverse probability of treatment weighting analysis, the risk of all-cause death, or nonfatal MI was significantly lower in patients receiving clopidogrel >12 months than in those receiving clopidogrel <= 12 months in diabetic patients (13.9% vs 8.4%, hazard ratio [HR] 0.57, 95% confidence interval [CI] 0.33 to 0.99, p = 0.046). However, no significant difference was observed in all-cause death or nonfatal MI between the two groups of patients without DM (5.0% vs 8.1%, HR 1.63, 95% CI 0.90 to 2.96, p = 0.11). Extended clopidogrel therapy beyond 12 months was associated with decreased risk of all-cause death or nonfatal MI in patients with DM after second-generation DES implantation. In conclusion, our data suggest that the benefits of extended clopidogrel therapy are more prominent in diabetic patients receiving second-generation DES implantation compared with nondiabetic patients. (C) 2018 Elsevier Inc. All rights reserved.
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