Triple antiplatelet therapy reduces ischemic events after drug-eluting stent implantation: Drug-Eluting stenting followed by Cilostazol treatment REduces Adverse Serious cardiac Events (DECREASE registry) - 05/08/11
, Sung-Cheol Yun, PhD, Young-Hak Kim, MD, PhD, Duk-Woo Park, MD, PhD, Won-Jang Kim, MD, Jong-Young Lee, MD, Cheol Whan Lee, MD, PhD, Myeong-Ki Hong, MD, PhD, Jae-Joong Kim, MD, PhD, Seung-Jung Park, MD, PhDRésumé |
Background |
Cilostazol has reduced restenosis and repeat intervention after drug-eluting stent (DES) implantation. However, there is little data regarding impact of cilostazol on cardiac events after DES implantation. Therefore, we assessed the long-term efficacy and safety of cilostazol in patients undergoing successful DES implantation.
Methods |
The patients (n = 3,099) undergoing successful DES implantation were treated with triple (aspirin, clopidogrel, and cilostazol; triple group, n = 1,443) or dual (aspirin and clopidogrel; dual group, n = 1,656) antiplatelet therapy. We compared adverse outcomes (death, myocardial infarction [MI], or stent thrombosis) at 12 months using the inverse probability of treatment weighted (IPTW) for the entire cohort and propensity score matching.
Results |
After IPTW adjustment, 12-month death (hazard ratio [HR] 0.762, 95% CI 0.401-1.448, P = .4062) was not different between the 2 groups. However, 12-month MI (HR 0.233, 95% CI 0.077-0.703, P = .0097) and stent thrombosis (HR 0.136, 95% CI 0.035-0.521, P = .0036) were significantly lower in triple group with no difference of major bleeding (HR 0.969, 95% CI 0.443-2.119, P = .9372). In the propensity score–matched cohort (965 pairs), 12-month clinical outcomes were similar to those of IPTW adjustment. On extended Cox model, duration of triple antiplatelet therapy was associated with reduction of stent thrombosis (HR 0.056, 95% CI 0.003-0.916, P = .0433) and MI (HR 0.749, 95% CI 0.568-0.988, P = .0408).
Conclusions |
Triple antiplatelet therapy significantly reduced 12-month risks of stent thrombosis and MI after DES implantation compared with dual antiplatelet therapy without increased risk of bleeding complications. The longer duration of triple therapy after DES implantation was associated with the lower risk of stent thrombosis and MI.
Le texte complet de cet article est disponible en PDF.Plan
Vol 159 - N° 2
P. 284 - février 2010 Retour au numéro
Article précédent
- Intracoronary thrombus formation after drug-eluting stents implantation: Optical coherence tomographic study
- Jung-Sun Kim, Myeong-Ki Hong, Chunyu Fan, Tae-Hoon Kim, Jae-Min Shim, Sang-Min Park, Young-Guk Ko, Donghoon Choi, Yangsoo Jang
- The effect of obesity on quality of life in patients with diabetes and coronary artery disease
- Mark A. Hlatky, Sheng-Chia Chung, Jorge Escobedo, William B. Hillegass, Kathryn Melsop, William Rogers, Maria M. Brooks, for the BARI 2D Study Group
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?