Duration of clopidogrel-based dual antiplatelet therapy and clinical outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention: A real-world observation in Taiwan from 2012 to 2015
Journal
Circulation Journal
Journal Volume
83
Journal Issue
6
Pages
1317-1323
Date Issued
2019
Author(s)
Li Y.-H.
Chiu Y.-W.
Cheng J.-J.
Hsieh I.-C.
Lo P.-H.
Lei M.-H.
Ueng K.-C.
Sung S.-H.
Kuo J.-Y.
Chen C.-P.
Lai W.-T.
Lee W.-L.
Chen J.-H.
Taiwan ACS STENT Registry Investigators
Abstract
BACKGROUND: Little information is available in Asia about the real-world practice of dual antiplatelet therapy (DAPT) duration for acute coronary syndrome (ACS) and its influence on clinical outcomes. METHODS AND RESULTS: The Taiwan ACS STENT Registry was a prospective, multicenter study to observe ACS patients using clopidogrel-based DAPT after percutaneous coronary intervention (PCI). The primary outcome was a composite of cardiovascular death, myocardial infarction, and stroke. Overall, 2,221 ACS patients (62 years, 83% men) were included. DAPT duration was ≤9 months in 935 (42.1%). The incidence of primary outcome was higher in patients receiving DAPT ≤9 months compared with those receiving DAPT >9 months at 1 year (3.5% vs. 1.6%, P=0.0026). The incidence of stent thrombosis (overall 0.5%) was similar between groups. Multivariable analysis showed that DAPT >9 months was associated with a significantly lower risk of primary outcome (odds ratio 0.725, 95% confidence interval 0.545-0.965). CONCLUSIONS: Our data showed that short duration of DAPT (≤9 months) was common (42.1%) in Taiwan for ACS patients undergoing PCI. DAPT ≤9 months increased the risk of the primary outcome.
SDGs
Type
journal article