Triple Versus Dual Antiplatelet Therapy in Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
- Authors
- Chen, Kang-Yin; Rha, Seung-Woon; Li, Yong-Jian; Poddar, Kanhaiya L.; Jin, Zhe; Minami, Yoshiyasu; Wang, Lin; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo; Jeong, Myung Ho; Ahn, Young Keun; Hong, Taek Jong; Kim, Young Jo; Hur, Seung Ho; Seong, In Whan; Chae, Jei Keon; Cho, Myeong Chan; Bae, Jang Ho; Choi, Dong Hoon; Jang, Yang Soo; Chae, In Ho; Kim, Chong Jin; Yoon, Jung Han; Chung, Wook Sung; Seung, Ki Bae; Park, Seung Jung
- Issue Date
- 30-6월-2009
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- cilostazol; myocardial infarction; thrombosis; platelets
- Citation
- CIRCULATION, v.119, no.25, pp.3207 - 3214
- Indexed
- SCIE
SCOPUS
- Journal Title
- CIRCULATION
- Volume
- 119
- Number
- 25
- Start Page
- 3207
- End Page
- 3214
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/119807
- DOI
- 10.1161/CIRCULATIONAHA.108.822791
- ISSN
- 0009-7322
- Abstract
- 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. (Circulation. 2009; 119: 3207-3214.)
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Collections - Graduate School > Department of Biomedical Sciences > 1. Journal Articles
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