Document Detail


Triple vs. dual antiplatelet therapy in patients with acute myocardial infarction and renal dysfunction.
MedLine Citation:
PMID:  22785460     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND:  The question as to whether triple antiplatelet therapy is superior to dual antiplatelet therapy for patients with acute myocardial infarction (AMI) and renal dysfunction, who undergo percutaneous coronary intervention (PCI), is unresolved.
METHODS AND RESULTS:  As part of the Korea Acute Myocardial Infarction Registry (KAMIR), 2,288 AMI patients with renal dysfunction (glomerular filtration rate <60ml/min·1.73m(2)) received either dual (aspirin plus clopidogrel; n=1,587) or triple (aspirin plus clopidogrel and cilostazol; n=701) antiplatelet therapy. Major adverse cardiac events (MACE) at 1 month and 1 year were compared between these 2 groups. On comparison with the dual therapy group, the triple therapy group had a similar incidence of major bleeding events but a significantly lower incidence of in-hospital mortality. The MACE rate at 1 month was significantly higher for the dual therapy group than for the triple therapy group (16.3% vs. 11.1%, P<0.05), and this difference was mainly attributed to death rather than repeat PCI (12.9% vs. 9.1%, P<0.05). The MACE rate at 1 year and the MACE-free survival time, however, did not differ between the groups.
CONCLUSIONS:  In AMI patients with renal dysfunction, triple antiplatelet therapy has a favorable in-hospital and short-term MACE impact, but it does not have an impact on the 1-year MACE-free survival.
Authors:
Young Hwan Choi; Sang Heon Suh; Joon Seok Choi; Chang Seong Kim; Doo Sun Sim; Eun Hui Bae; Sang Yup Lim; Seong Kwon Ma; Myung Ho Jeong; Soo Wan Kim;
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2012-07-03
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  76     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2012  
Date Detail:
Created Date:  2012-09-25     Completed Date:  2013-02-14     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2405-11     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Chonnam National University Medical School, Jaebongro 671, Dongku, Gwangju 501-757, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aspirin / administration & dosage*,  adverse effects
Disease-Free Survival
Drug Therapy, Combination
Female
Humans
Kidney Diseases* / complications,  mortality,  physiopathology,  therapy
Male
Middle Aged
Myocardial Infarction* / complications,  mortality,  physiopathology,  therapy
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors / administration & dosage*,  adverse effects
Survival Rate
Tetrazoles / administration & dosage*,  adverse effects
Ticlopidine / administration & dosage,  adverse effects,  analogs & derivatives*
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 0/Tetrazoles; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; A74586SNO7/clopidogrel; N7Z035406B/cilostazol
Investigator
Investigator/Affiliation:
Myung Ho Jeong / ; Young Keun Ahn / ; Sung Chull Chae / ; Jong Hyun Kim / ; Seung Ho Hur / ; Young Jo Kim / ; In Whan Seong / ; Dong Hoon Choi / ; Jei Keon Chae / ; Taek Jong Hong / ; 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 / ; Myeong Chan Cho / ; Seok Kyu / ; Nae Hee Lee / ; Tae Jeong Kyoung / ; Seung Jea Tahk / ; Jang Ho Bae / ; Seung Woon / ; Seung Woon Rha / ; Keum Soo Park / ; Chong Jin Kim / ; Kyoo Rok Han / ; Tae Hoon Ahn / ; Moo Hyun Kim / ; Ki Bae Seung / ; Wook Sung Chung / ; 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 / ; Byung Ok Kim / ; Sang-Wook Kim / ; Kyung Kim / ; Tae Ik Kim / ; Deug Young Nah / ; Si Hoon Park / ; Sang Hyun Lee / ; Seung Uk Lee / ; Hang-Jae Chung / ; Jang Hyun Cho / ; Seung Won Jin / ; Yang Soo Jang / ; Jeong Gwan Cho / ; Seung Jung Park /

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