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Long-term Outcomes of Clopidogrel Monotherapy versus Prolonged Dual Antiplatelet Therapy beyond 12 Months after Percutaneous Coronary Intervention in High-risk Patients

Journal of Korean Medical Science 2021년 36권 16호 p.106 ~ 106
김동연, 조성우, 박규태, 안종화, 박택규, 장용호, 최기홍, 이주명, 양정훈, 송영빈, 최진호, 최승혁, 권현철, 이상훈, 한주용,
소속 상세정보
김동연 ( Kim Dong-Yeon ) - Inje University College of Medicine Seoul Paik Hospital Department of Internal Medicine
조성우 ( Cho Sung-Woo ) - Inje University College of Medicine Ilsan Paik Hospital Department of Internal Medicine
박규태 ( Park Kyu-Tae ) - Hallym University Chuncheon Sacred Heart Hospital Department of Internal Medicine
안종화 ( Ahn Jong-Hwa ) - Gyeongsang National University Changwon Hospital Department of Internal Medicine
박택규 ( Park Taek-Kyu ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
장용호 ( Jang Yong-Ho ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
최기홍 ( Choi Ki-Hong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
이주명 ( Lee Joo-Myung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
양정훈 ( Yang Jeong-Hoon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
송영빈 ( Song Young-Bin ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
최진호 ( Choi Jin-Ho ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
최승혁 ( Choi Seung-Hyuk ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
권현철 ( Gwon Hyeon-Cheol ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
이상훈 ( Lee Sang-Hoon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
한주용 ( Hahn Joo-Yong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine

Abstract


Background: There are no data on comparison between clopidogrel monotherapy and prolonged dual antiplatelet therapy (DAPT) in patients at high-risk undergoing percutaneous coronary intervention (PCI).

Methods: Of 2,082 consecutive patients undergoing PCI using second-generation drug-eluting stent (DES), we studied 637 patients at high-risk either angiographically or clinically who received clopidogrel longer than 24 months and were event-free at 12 months after index PCI. Patients were divided into 2 groups: the clopidogrel monotherapy group and the prolonged DAPT group. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction (MI), definite or probable stent thrombosis, or stroke between 12 months and 36 months after the index PCI.

Results: In propensity score-matched population (246 pairs), the cumulative rate of primary outcome was 4.5% in the clopidogrel monotherapy group and 4.9% in the prolonged DAPT group (hazard ratio, 1.21; 95% confidence interval, 0.54?2.75; P = 0.643). There was no significant difference in all-cause death, MI, stent thrombosis, stroke between the clopidogrel monotherapy group and the prolonged DAPT group.

Conclusion: Compared with prolonged DAPT, clopidogrel monotherapy showed similar long-term outcomes in patients at high-risk after second-generation DES implantation.

키워드

Clopidogrel; Dual Antiplatelet Therapy; Percutaneous Coronary Intervention; Drug-eluting Stent

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