| Triple versus dual antiplatelet therapy in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. | |
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MedLine Citation:
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PMID: 19528339 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Whether triple antiplatelet therapy is superior or similar to dual antiplatelet therapy in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention in the era of drug-eluting stents remains unclear. METHODS AND RESULTS: A total of 4203 ST-segment elevation myocardial infarction patients who underwent primary percutaneous coronary intervention with drug-eluting stents were analyzed retrospectively in the Korean Acute Myocardial Infarction Registry (KAMIR). They received either dual (aspirin plus clopidogrel; dual group; n=2569) or triple (aspirin plus clopidogrel plus cilostazol; triple group; n=1634) antiplatelet therapy. The triple group received additional cilostazol at least for 1 month. Various major adverse cardiac events at 8 months were compared between these 2 groups. Compared with the dual group, the triple group had a similar incidence of major bleeding events but a significantly lower incidence of in-hospital mortality. Clinical outcomes at 8 months showed that the triple group had significantly lower incidences of cardiac death (adjusted odds ratio, 0.52; 95% confidence interval, 0.32 to 0.84; P=0.007), total death (adjusted odds ratio, 0.60; 95% confidence interval, 0.41 to 0.89; P=0.010), and total major adverse cardiac events (adjusted odds ratio, 0.74; 95% confidence interval, 0.58 to 0.95; P=0.019) than the dual group. Subgroup analysis showed that older (>65 years old), female, and diabetic patients got more benefits from triple antiplatelet therapy than their counterparts who received dual antiplatelet therapy. CONCLUSIONS: Triple antiplatelet therapy seems to be superior to dual antiplatelet therapy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with drug-eluting stents. These results may provide the rationale for the use of triple antiplatelet therapy in these patients. |
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Authors:
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Kang-Yin Chen; Seung-Woon Rha; Yong-Jian Li; Kanhaiya L Poddar; Zhe Jin; Yoshiyasu Minami; Lin Wang; Eung Ju Kim; Chang Gyu Park; Hong Seog Seo; Dong Joo Oh; Myung Ho Jeong; Young Keun Ahn; Taek Jong Hong; Young Jo Kim; Seung Ho Hur; In Whan Seong; Jei Keon Chae; Myeong Chan Cho; Jang Ho Bae; Dong Hoon Choi; Yang Soo Jang; In Ho Chae; Chong Jin Kim; Jung Han Yoon; Wook Sung Chung; Ki Bae Seung; Seung Jung Park; |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2009-06-15 |
Journal Detail:
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Title: Circulation Volume: 119 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-06-30 Completed Date: 2009-07-22 Revised Date: 2010-03-04 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 3207-14 Citation Subset: AIM; IM |
Affiliation:
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Korea University Guro Hospital, Seoul, Korea. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Aspirin / therapeutic use Combined Modality Therapy Coronary Thrombosis / prevention & control* Drug Therapy, Combination Drug-Eluting Stents* Electrocardiography Female Humans Male Middle Aged Myocardial Infarction / diagnosis, drug therapy*, mortality* Platelet Aggregation Inhibitors / therapeutic use* Proportional Hazards Models Registries Retrospective Studies Tetrazoles / therapeutic use Ticlopidine / analogs & derivatives, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Platelet Aggregation Inhibitors; 0/Tetrazoles; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 73963-72-1/cilostazol; 90055-48-4/clopidogrel |
| Investigator | |
Investigator/Affiliation:
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Myung Ho Jeong / ; Young Jo Kim / ; Chong Jin Kim / ; Myeong Chan Cho / ; Young Keun Ahn / ; Jong Hyun Kim / ; Shung Chull Chae / ; Seung Ho Hur / ; In Whan Seong / ; Taek Jong Hong / ; Dong Hoon Choi / ; Jei Keon Chae / ; Jae Young Rhew / ; Doo Il Kim / ; In Ho Chae / ; Jung Han Yoon / ; Bon Kwon Koo / ; Byung Ok Kim / ; Myoung Yong Lee / ; Kee Sik Kim / ; Jin Yong Hwang / ; Seok Kyu Oh / ; Nae Hee Lee / ; Kyoung Tae Jeong / ; Seung Jea Tahk / ; Jang Ho Bae / ; Seung Woon Rha / ; Keum Soo Park / ; Kyoo Rok Han / ; Tae Hoon Ahn / ; Moo Hyun Kim / ; Ju Young Yang / ; Chong Yun Rhim / ; Hyeon Cheol Gwon / ; Seong Wook Park / ; Young Youp Koh / ; Seung Jae Joo / ; Soo Joong Kim / ; Dong Kyu Jin / ; Jin Man Cho / ; Jeong Gwan Cho / ; Wook Sung Chung / ; Yang Soo Jang / ; Ki Bae Seung / ; Seung Jung Park / |
| Comments/Corrections | |
Comment In:
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Circulation. 2010 Feb 23;121(7):e43; author reply e44-5
[PMID:
20177003
]
Circulation. 2009 Jun 30;119(25):3168-70 [PMID: 19528332 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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