Duration of dual antiplatelet therapy following percutaneous coronary intervention on re-hospitalization for acute coronary syndrome

BMC Cardiovascular Disorders

Churn-Shiouh Gau⁴  William Wei-Yuan Hsu¹  Chii-Ming Lee²  Fei-Yuan Hsiao³  Shih-Chin Chen⁵ 

[1] Institute of Information Science, Academia Sinica, Taipei, Taiwan;Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan;Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan;Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan;Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, 33, Linsen South Road, Taipei, Taiwan

关键词: Drug eluting stent (DES);    Dual antiplatelet therapy;    Clopidogrel;    Percutaneous coronary intervention (PCI);    Acute coronary syndrome (ACS);   

Others  :  855385
DOI  :  10.1186/1471-2261-14-21

 received in 2013-09-04, accepted in 2014-01-28,  发布年份 2014

【 摘 要 】

Background

The optimal duration of dual antiplatelet therapy after percutaneous coronary intervention (PCI) remains uncertain. The objective of this study was to examine the association between duration of dual antiplatelet therapy and re-hospitalization for acute coronary syndrome (ACS) in ACS patients who underwent PCI.

Methods

We identified 975 newly diagnosed ACS patients who underwent PCI between July, 2007 and June, 2009, at a medical center in Taiwan. Cox proportional hazard models were used to examine the association between duration of dual antiplatelet therapy (9 months, 12 months and 15 months) and risks of re-hospitalization for ACS.

Results

At a mean follow-up of 2.3 years, we found that use of clopidogrel for ≥ 12 months was associated with a decreased risk of re-hospitalization for ACS (adjusted HR 0.59, 95% CI 0.36-0.95; p = 0.03). However, use of clopidogrel for ≥ 15 months was not associated with a decreased risk of re-hospitalization for ACS (adjusted HR 0.57, 95% CI 0.29-1.13; p = 0.11). Similar results were found in patients who implanted drug-eluting stents (DES), for whom at least 12 months of clopidogrel therapy is especially critical.

Conclusion

The benefit of ≥ 12 months of clopidogrel use in reducing the risk of re-hospitalization for ACS was significant among ACS patients who underwent PCI and was especially critical for those who implanted DES.

【 授权许可】

   
2014 Chen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 3.

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