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Open Access 01-12-2014 | Research article

Clopidogrel discontinuation within the first year after coronary drug-eluting stent implantation: an observational study

Authors: Troels Thim, Martin Berg Johansen, Gro Egholm Chisholm, Morten Schmidt, Anne Kaltoft, Henrik Toft Sørensen, Leif Thuesen, Steen Dalby Kristensen, Hans Erik Bøtker, Lars Romer Krusell, Jens Flensted Lassen, Per Thayssen, Lisette Okkels Jensen, Hans-Henrik Tilsted, Michael Maeng

Published in: BMC Cardiovascular Disorders | Issue 1/2014

Abstract

Background

The impact of adherence to the recommended duration of dual antiplatelet therapy after first generation drug-eluting stent implantation is difficult to assess in real-world settings and limited data are available.

Methods

We followed 4,154 patients treated with coronary drug-eluting stents in Western Denmark for 1 year and obtained data on redeemed clopidogrel prescriptions and major adverse cardiovascular events (MACE, i.e., cardiac death, myocardial infarction, or stent thrombosis) from medical databases.

Results

Discontinuation of clopidogrel within the first 3 months after stent implantation was associated with a significantly increased rate of MACE at 1-year follow-up (hazard ratio (HR) 2.06; 95% confidence interval (CI): 1.08-3.93). Discontinuation 3-6 months (HR 1.29; 95% CI: 0.70-2.41) and 6-12 months (HR 1.29; 95% CI: 0.54-3.07) after stent implantation were associated with smaller, not statistically significant, increases in MACE rates. Among patients who discontinued clopidogrel, MACE rates were highest within the first 2 months after discontinuation.

Conclusions

Discontinuation of clopidogrel was associated with an increased rate of MACE among patients treated with drug-eluting stents. The increase was statistically significant within the first 3 months after drug-eluting stent implantation but not after 3 to 12 months.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2261/14/100/prepub

Title: Clopidogrel discontinuation within the first year after coronary drug-eluting stent implantation: an observational study
Authors: Troels Thim
Martin Berg Johansen
Gro Egholm Chisholm
Morten Schmidt
Anne Kaltoft
Henrik Toft Sørensen
Leif Thuesen
Steen Dalby Kristensen
Hans Erik Bøtker
Lars Romer Krusell
Jens Flensted Lassen
Per Thayssen
Lisette Okkels Jensen
Hans-Henrik Tilsted
Michael Maeng
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Cardiovascular Disorders / Issue 1/2014
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/1471-2261-14-100

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