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.
journal_name
Korean Circ Jjournal_title
Korean circulation journalauthors
Sim DS,Jeong MH,Kim HS,Gwon HC,Seung KB,Rha SW,Chae SC,Kim CJ,Cha KS,Park JS,Yoon JH,Chae JK,Joo SJ,Choi DJ,Hur SH,Seong IW,Cho MC,Kim DI,Oh SK,Ahn TH,Hwang JY,KAMIR-NIH registry investigators.doi
10.4070/kcj.2019.0166subject
Has Abstractpub_date
2020-02-01 00:00:00pages
120-129issue
2eissn
1738-5520issn
1738-5555pii
50.e5journal_volume
50pub_type
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