Duration of Clopidogrel-Based Dual Antiplatelet Therapy and Clinical Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention ― A Real-World Observation in Taiwan From 2012 to 2015 ―
Open Access
- 24 May 2019
- journal article
- research article
- Published by Japanese Circulation Society in Circulation Journal
- Vol. 83 (6), 1317-1323
- https://doi.org/10.1253/circj.cj-18-1283
Abstract
Background:Little information is available in Asia about the real-world practice of dual antiplatelet therapy (DAPT) duration for acute coronary syndrome (ACS) and its influence on clinical outcomes. Methods and Results:The Taiwan ACS STENT Registry was a prospective, multicenter study to observe ACS patients using clopidogrel-based DAPT after percutaneous coronary intervention (PCI). The primary outcome was a composite of cardiovascular death, myocardial infarction, and stroke. Overall, 2,221 ACS patients (62 years, 83% men) were included. DAPT duration was ≤9 months in 935 (42.1%). The incidence of primary outcome was higher in patients receiving DAPT ≤9 months compared with those receiving DAPT >9 months at 1 year (3.5% vs. 1.6%, P=0.0026). The incidence of stent thrombosis (overall 0.5%) was similar between groups. Multivariable analysis showed that DAPT >9 months was associated with a significantly lower risk of primary outcome (odds ratio 0.725, 95% confidence interval 0.545–0.965). Conclusions:Our data showed that short duration of DAPT (≤9 months) was common (42.1%) in Taiwan for ACS patients undergoing PCI. DAPT ≤9 months increased the risk of the primary outcome.Keywords
This publication has 24 references indexed in Scilit:
- 6-Month Versus 12-Month Dual-Antiplatelet Therapy Following Long Everolimus-Eluting Stent ImplantationJACC: Cardiovascular Interventions, 2016
- 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery DiseaseJournal of Invasive Cardiology, 2016
- Six Versus 12 Months of Dual Antiplatelet Therapy After Implantation of Biodegradable Polymer Sirolimus-Eluting StentCirculation: Cardiovascular Interventions, 2016
- Impact of prolonged dual antiplatelet therapy after acute myocardial infarction on 5-year mortality in the FAST-MI 2005 registryInternational Journal of Cardiology, 2015
- World Heart Federation expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCINature Reviews Cardiology, 2014
- Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational studyThe Lancet, 2013
- Management and Two-Year Long-Term Clinical Outcome of Acute Coronary Syndrome in JapanCirculation Journal, 2013
- Ticagrelor versus Clopidogrel in Patients with Acute Coronary SyndromesThe New England Journal of Medicine, 2009
- Ethnic variation in adverse cardiovascular outcomes and bleeding complications in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) studyAmerican Heart Journal, 2009
- Prasugrel versus Clopidogrel in Patients with Acute Coronary SyndromesThe New England Journal of Medicine, 2007