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- Title
Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study.
- Authors
Sørensen R; Abildstrom SZ; Weeke P; Fosbøl EL; Folke F; Hansen ML; Hansen PR; Madsen JK; Abildgaard U; Køber L; Poulsen HE; Torp-Pedersen C; Gislason GH; Sørensen, Rikke; Abildstrom, Steen Z; Weeke, Peter; Fosbøl, Emil L; Folke, Fredrik; Hansen, Morten L; Hansen, Peter R
- Abstract
<bold>Background: </bold>The optimal duration of clopidogrel treatment after percutaneous coronary intervention (PCI) is unclear. We studied the risk of death or recurrent myocardial infarction (MI) in relation to 6- and 12-months clopidogrel treatment among MI patients treated with PCI.<bold>Methods: </bold>Using nationwide registers of hospitalizations and drug dispensing from pharmacies we identified 11 680 patients admitted with MI, treated with PCI and clopidogrel. Clopidogrel treatment was categorized in a 6-months and a 12-months regimen. Rates of death, recurrent MI or a combination of both were analyzed by the Kaplan Meier method and Cox proportional hazards models. Bleedings were compared between treatment regimens.<bold>Results: </bold>The Kaplan Meier analysis indicated no benefit of the 12-months regimen compared with the 6-months in all endpoints. The Cox proportional hazards analysis confirmed these findings with hazard ratios for the 12-months regimen (the 6-months regimen used as reference) for the composite endpoint of 1.01 (confidence intervals 0.81-1.26) and 1.24 (confidence intervals 0.95-1.62) for Day 0-179 and Day 180-540 after discharge. Bleedings occurred in 3.5% and 4.1% of the patients in the 6-months and 12-months regimen (p = 0.06).<bold>Conclusions: </bold>We found comparable rates of death and recurrent MI in patients treated with 6- and 12-months' clopidogrel. The potential benefit of prolonged clopidogrel treatment in a real-life setting remains uncertain.
- Publication
BMC Cardiovascular Disorders, 2010, Vol 10, p6
- ISSN
1471-2261
- Publication type
journal article
- DOI
10.1186/1471-2261-10-6