TY - JOUR
T1 - Comparison of the Impact of Short (<1 Year) and Long-Term (≥1 Year) Clopidogrel Use Following Percutaneous Coronary Intervention on Mortality
AU - Banerjee, Subhash
AU - Varghese, Cyril
AU - Samuel, Jepsin
AU - Weideman, Rick A.
AU - Little, Bertis B.
AU - Kelly, Kevin C.
AU - Rao, Sunil V.
AU - Reilly, Robert F.
AU - Brilakis, Emmanouil S.
PY - 2008/11/1
Y1 - 2008/11/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.amjcard.2008.06.058
DO - 10.1016/j.amjcard.2008.06.058
M3 - Article
C2 - 18940284
AN - SCOPUS:54549102273
SN - 0002-9149
VL - 102
SP - 1159
EP - 1162
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 9
ER -