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BMC Cardiovascular Disorders

, 14:100

Coronary artery disease

Abstract

BackgroundThe impact of adherence to the recommended duration of dual antiplatelet therapy after first generation drug-eluting stent implantation is difficult to assess in real-world settings and limited data are available.

MethodsWe followed 4,154 patients treated with coronary drug-eluting stents in Western Denmark for 1 year and obtained data on redeemed clopidogrel prescriptions and major adverse cardiovascular events MACE, i.e., cardiac death, myocardial infarction, or stent thrombosis from medical databases.

ResultsDiscontinuation of clopidogrel within the first 3 months after stent implantation was associated with a significantly increased rate of MACE at 1-year follow-up hazard ratio HR 2.06; 95% confidence interval CI: 1.08-3.93. Discontinuation 3-6 months HR 1.29; 95% CI: 0.70-2.41 and 6-12 months HR 1.29; 95% CI: 0.54-3.07 after stent implantation were associated with smaller, not statistically significant, increases in MACE rates. Among patients who discontinued clopidogrel, MACE rates were highest within the first 2 months after discontinuation.

ConclusionsDiscontinuation of clopidogrel was associated with an increased rate of MACE among patients treated with drug-eluting stents. The increase was statistically significant within the first 3 months after drug-eluting stent implantation but not after 3 to 12 months.

KeywordsPercutaneous coronary intervention Dual antiplatelet therapy Drug-eluting stent Clopidogrel AbbreviationsCIConfidence interval

HRHazard ratio

MACEMajor adverse cardiovascular events

PCIPercutaneous coronary intervention

WDHRWestern Denmark Heart Registry.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2261-14-100 contains supplementary material, which is available to authorized users.

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Author: Troels Thim - Martin Berg Johansen - Gro Egholm Chisholm - Morten Schmidt - Anne Kaltoft - Henrik Toft Sørensen - Leif 

Source: https://link.springer.com/article/10.1186/1471-2261-14-100



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