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Comparison of three-year clinical outcomes with nonextended versus extended dual antiplatelet therapy between first- and second-generation drug-eluting stent implantation in patients with acute myocardial infarction: data from the infarct prognosis study registry

Authors
 KI-WOON KANG  ;  BYEONG-KEUK KIM  ;  JI-YONG JANG  ;  HYE SUN LEE  ;  JUNG-SUN KIM  ;  YOUNG-GUK KO  ;  JONGWON HA  ;  DONGHOON CHOI  ;  MYEONG-KI HONG  ;  YANGSOO JANG 
Citation
 JOURNAL OF INTERVENTIONAL CARDIOLOGY, Vol.25(3) : 245-252, 2012 
Journal Title
JOURNAL OF INTERVENTIONAL CARDIOLOGY
ISSN
 0896-4327 
Issue Date
2012
MeSH
Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease/drug therapy* ; Coronary Artery Disease/therapy ; Coronary Thrombosis/prevention & control ; Drug Administration Schedule ; Drug Therapy, Combination ; Drug-Eluting Stents*/adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction/drug therapy ; Myocardial Infarction/therapy* ; Platelet Aggregation Inhibitors/administration & dosage* ; Platelet Aggregation Inhibitors/adverse effects ; Prognosis ; Treatment Outcome
Keywords
Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease/drug therapy* ; Coronary Artery Disease/therapy ; Coronary Thrombosis/prevention & control ; Drug Administration Schedule ; Drug Therapy, Combination ; Drug-Eluting Stents*/adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction/drug therapy ; Myocardial Infarction/therapy* ; Platelet Aggregation Inhibitors/administration & dosage* ; Platelet Aggregation Inhibitors/adverse effects ; Prognosis ; Treatment Outcome
Abstract
BACKGROUND: The difference of the clinical outcomes between nonextended (≤12 months) and extended (>12 months) dual antiplatelet therapy (DAPT) remains unclear in patients with acute myocardial infarction (AMI) implanted by different generations of drug-eluting stent (DES).

METHODS: We identified 790 consecutive patients with AMI who were free from major adverse cardiac events for 12 months after first-generation (n = 537) or second-generation DES (n = 253) implantation; each DES generation group was further divided into nonextended and extended DAPT.

RESULTS: During follow-up (median: 40 months), nonextended DAPT in the first-generation DES group showed a higher rate of cardiac death or MI than was observed in the extended DAPT group (14% vs 2%, P < 0.001). However, in the second-generation DES group, there was no difference in the occurrence of cardiac death and MI between the extended and nonextended groups (4% vs 3%, P = 0.809). Nonextended DAPT was the most significant predictor of cardiac death and MI for first-generation DES implantation [hazard ratio (HR) = 5.47, 95% confidence interval (CI) = 1.53-19.59, P = 0.009] but not for second-generation DES implantation [HR = 3.21, 95% CI = 0.21-50.65, P = 0.401].

CONCLUSION: This study suggested that the clinical outcomes between nonextended and extended DAPT might be different depending on the generation of implanted DESs in patients with AMI.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8183.2012.00719.x/abstract
DOI
22409626
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Medical Engineering (의학공학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Jang, Ji Yong(장지용)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90863
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