Long-term Outcomes of Clopidogrel Monotherapy versus Prolonged Dual Antiplatelet Therapy beyond 12 Months after Percutaneous Coronary Intervention in High-risk Patients
10.3346/jkms.2021.36.e106
- Author:
Dong-Yeon KIM
1
;
Sung Woo CHO
;
Kyu Tae PARK
;
Jong-Hwa AHN
;
Taek Kyu PARK
;
Yong Ho JANG
;
Ki Hong CHOI
;
Joo Myung LEE
;
Jeong Hoon YANG
;
Young Bin SONG
;
Jin-Ho CHOI
;
Seung-Hyuk CHOI
;
Hyeon-Cheol GWON
;
Sang Hoon LEE
;
Joo-Yong HAHN
Author Information
1. Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2021;36(16):e106-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:There are no data on comparison between clopidogrel monotherapy and prolonged dual antiplatelet therapy (DAPT) in patients at high-risk undergoing percutaneous coronary intervention (PCI).
Methods:Of 2,082 consecutive patients undergoing PCI using second-generation drugeluting stent (DES), we studied 637 patients at high-risk either angiographically or clinically who received clopidogrel longer than 24 months and were event-free at 12 months after index PCI. Patients were divided into 2 groups: the clopidogrel monotherapy group and the prolonged DAPT group. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction (MI), definite or probable stent thrombosis, or stroke between 12 months and 36 months after the index PCI.
Results:In propensity score-matched population (246 pairs), the cumulative rate of primary outcome was 4.5% in the clopidogrel monotherapy group and 4.9% in the prolonged DAPT group (hazard ratio, 1.21; 95% confidence interval, 0.54–2.75; P = 0.643). There was no significant difference in all-cause death, MI, stent thrombosis, stroke between the clopidogrel monotherapy group and the prolonged DAPT group.
Conclusion:Compared with prolonged DAPT, clopidogrel monotherapy showed similar long-term outcomes in patients at high-risk after second-generation DES implantation.
