Clopidogrel versus Aspirin after Dual Antiplatelet Therapy in Acute Myocardial Infarction Patients Undergoing Drug-Eluting Stentingopen accessClopidogrel versus Aspirin after Dual Antiplatelet Therapy in Acute Myocardial Infarction Patients Undergoing Drug-Eluting Stenting
- Other Titles
- Clopidogrel versus Aspirin after Dual Antiplatelet Therapy in Acute Myocardial Infarction Patients Undergoing Drug-Eluting Stenting
- Doo Sun Sim; Myung 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 Hur; In Whan Seong; Myeong Chan Cho; Doo-Il Kim; Seok Kyu Oh; Tae Hoon Ahn; Jin-Yong Hwang
- Issue Date
- Antiplatelet agents; Drug-eluting stents; Myocardial infarction
- Korean Circulation Journal, v.50, no.2, pp.120 - 129
- Journal Title
- Korean Circulation Journal
- Start Page
- End Page
- 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.
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