Comparison of the Impact of Short (<1 Year) and Long-Term (≥1 Year) Clopidogrel Use Following Percutaneous Coronary Intervention on Mortality

Subhash Banerjee, Cyril Varghese, Jepsin Samuel, Rick A. Weideman, Bertis B. Little, Kevin C. Kelly, Sunil V. Rao, Robert F. Reilly, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

The optimal duration of clopidogrel administration after percutaneous coronary intervention (PCI) remains unknown. Clopidogrel is currently recommended for minimums of 1 and 12 months after bare-metal stent and drug-eluting stent implantation, respectively. To determine the impact of clopidogrel discontinuation 1 year after PCI, the outcomes of 530 consecutive patients who underwent PCI from January 2004 to July 2006, were free of cardiovascular events for 6 months after PCI, and had follow-up available for >12 months were examined. The outcomes of patients who received clopidogrel for ≥1 year were compared with those of patients who received it for <1 year. The mean age was 65 ± 9 years. Patients often presented with acute coronary syndromes (57%), and 85% received drug-eluting stents. Clopidogrel was used for ≥1 year and for <1 year in 341 and 189 patients, respectively. During a mean follow-up period of 2.4 ± 0.8 years, 40 patients (8%) died, 21 (4%) had acute myocardial infarctions, and 89 (17%) underwent repeat coronary revascularization. Compared with patients with clopidogrel administration for <1 year after PCI, those who received clopidogrel for ≥1 year had lower mortality (14.8% vs 3.5%, p <0.001). On multivariate analysis, clopidogrel use for ≥1 year was associated with lower mortality (hazard ratio 0.28, 95% confidence interval 0.14 to 0.59), independent of traditional cardiovascular risk factors, clinical presentation, and the use of drug-eluting stents. In conclusion, the use of clopidogrel for ≥1 year after PCI was associated with lower mortality.

Original languageEnglish (US)
Pages (from-to)1159-1162
Number of pages4
JournalAmerican Journal of Cardiology
Volume102
Issue number9
DOIs
StatePublished - Nov 1 2008

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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