Clopidogrel versus Aspirin after Dual Antiplatelet Therapy in Acute Myocardial Infarction Patients Undergoing Drug-Eluting Stenting
- Author:
Doo Sun SIM
1
;
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
;
Author Information
- Publication Type:Original Article
- Keywords: Antiplatelet agents; Drug-eluting stents; Myocardial infarction
- MeSH: Aspirin; Drug-Eluting Stents; Hemorrhage; Humans; Incidence; Korea; Myocardial Infarction; Percutaneous Coronary Intervention; Platelet Aggregation Inhibitors; Stents; Stroke; Thrombosis
- From:Korean Circulation Journal 2020;50(2):120-129
- CountryRepublic of Korea
- Language:English
- 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.
