Document Detail


Prolonged dual antiplatelet therapy improves clinical outcomes in high-risk patients implanted with sirolimus-eluting stents.
MedLine Citation:
PMID:  19301293     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although a science advisory recommending 12 months of dual antiplatelet therapy after drug-eluting stents implantation was published recently, the optimal duration of dual antiplatelet therapy has not yet been precisely determined. HYPOTHESIS: Prolonged dual antiplatelet therapy can improve clinical outcomes in high-risk patients implanted with sirolimus-eluting stents. METHODS: The patients implanted with sirolimus-eluting stents were assigned into standard clopidogrel therapy group (clopidogrel 75 mg/d for 12 mo) and prolonged clopidogrel therapy group (clopidogrel 75 mg/d for 18 mo). Long-term aspirin (100 mg/d) therapy was adopted in both groups. The primary endpoint was very late stent thrombosis. RESULTS: After 12 months, 24 patients were excluded because of major adverse cardiovascular events (MACEs). Three hundred and thirty six patients surviving without MACEs were further followed up for 6 months. Between 12 and 18 months, in 160 patients with standard clopidogrel therapy, 5.6% had very late stent thrombosis. In contrast, in 176 patients with prolonged clopidogrel therapy, 1.1% had very late stent thrombosis (p<0.01, versus standard clopidogrel therapy group). CONCLUSIONS: Prolonged dual antiplatelet therapy may be beneficial to prevent very late stent thrombosis after sirolimus-eluting stents implantation in high-risk patients.
Authors:
Jia Dean; Zhou Yujie; Zhao Yingxin; Liu Yuyang; Guo Yonghe; Cheng Wanjun; Cao Zheng
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  32     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-25     Completed Date:  2009-05-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  164-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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MeSH Terms
Descriptor/Qualifier:
Aspirin / administration & dosage*
Chi-Square Distribution
Coronary Artery Disease / therapy*
Drug-Eluting Stents*
Female
Graft Occlusion, Vascular / prevention & control*
Humans
Immunosuppressive Agents / administration & dosage*
Male
Platelet Aggregation Inhibitors / administration & dosage*
Retrospective Studies
Sirolimus / administration & dosage*
Ticlopidine / administration & dosage,  analogs & derivatives*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 53123-88-9/Sirolimus; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel

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