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

BMC Cardiovascular Disorders

Research Article

William Wei-Yuan Hsu¹  Chii-Ming Lee²  Shih-Chin Chen³  Churn-Shiouh Gau⁴  Fei-Yuan Hsiao⁵ 

[1] Department of Computer Science and Engineering, National Taiwan Ocean University, Keelung, Taiwan;Institute of Information Science, Academia Sinica, Taipei, Taiwan;Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan;Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, 33, Linsen South Road, Taipei, Taiwan;Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, 33, Linsen South Road, Taipei, Taiwan;Center for Drug Evaluation, 3F, No. 465, Zhongxiao E. Rd. Sec. 6, 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;School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan;Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan;

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

DOI  :  10.1186/1471-2261-14-21

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

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsWe 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.ResultsAt 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.ConclusionThe 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】

Unknown   
© Chen et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.