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

Troels Thim; Martin Berg Johansen; Gro Egholm Chisholm; Morten Hvid 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

doi:10.1186/1471-2261-14-100

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

Troels Thim, Martin Berg Johansen, Gro Egholm Chisholm, Morten Hvid 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

28 Citations (Scopus)

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.

Original language	English
Journal	B M C Cardiovascular Disorders
Volume	14
Pages (from-to)	100
ISSN	1471-2261
DOIs	https://doi.org/10.1186/1471-2261-14-100
Publication status	Published - 2014

Keywords

Aged
Coronary Thrombosis
Denmark
Drug Administration Schedule
Drug Prescriptions
Drug-Eluting Stents
Female
Humans
Male
Medication Adherence
Middle Aged
Myocardial Infarction
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Ticlopidine
Time Factors
Treatment Outcome

Access to Document

10.1186/1471-2261-14-100

Cite this

Thim, T., Johansen, M. B., Chisholm, G. E., Schmidt, M. H., Kaltoft, A., Sørensen, H. T., Thuesen, L., Kristensen, S. D., Bøtker, H. E., Krusell, L. R., Lassen, J. F., Thayssen, P., Jensen, L. O., Tilsted, H.-H., & Maeng, M. (2014). Clopidogrel discontinuation within the first year after coronary drug-eluting stent implantation: an observational study. B M C Cardiovascular Disorders, 14, 100. https://doi.org/10.1186/1471-2261-14-100

Thim, T, Johansen, MB, Chisholm, GE, Schmidt, MH, Kaltoft, A, Sørensen, HT, Thuesen, L, Kristensen, SD, Bøtker, HE, Krusell, LR, Lassen, JF, Thayssen, P, Jensen, LO, Tilsted, H-H & Maeng, M 2014, 'Clopidogrel discontinuation within the first year after coronary drug-eluting stent implantation: an observational study', B M C Cardiovascular Disorders, vol. 14, pp. 100. https://doi.org/10.1186/1471-2261-14-100

@article{1074d4d029574845a457951e96f579f3,

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

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.",

keywords = "Aged, Coronary Thrombosis, Denmark, Drug Administration Schedule, Drug Prescriptions, Drug-Eluting Stents, Female, Humans, Male, Medication Adherence, Middle Aged, Myocardial Infarction, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Ticlopidine, Time Factors, Treatment Outcome",

author = "Troels Thim and Johansen, \{Martin Berg\} and Chisholm, \{Gro Egholm\} and Schmidt, \{Morten Hvid\} and Anne Kaltoft and S{\o}rensen, \{Henrik Toft\} and Leif Thuesen and Kristensen, \{Steen Dalby\} and B{\o}tker, \{Hans Erik\} and Krusell, \{Lars Romer\} and Lassen, \{Jens Flensted\} and Per Thayssen and Jensen, \{Lisette Okkels\} and Hans-Henrik Tilsted and Michael Maeng",

year = "2014",

doi = "10.1186/1471-2261-14-100",

language = "English",

volume = "14",

pages = "100",

journal = "B M C Cardiovascular Disorders",

issn = "1471-2261",

publisher = "BioMed Central Ltd",

}

TY - JOUR

T1 - Clopidogrel discontinuation within the first year after coronary drug-eluting stent implantation

T2 - an observational study

AU - Thim, Troels

AU - Johansen, Martin Berg

AU - Chisholm, Gro Egholm

AU - Schmidt, Morten Hvid

AU - Kaltoft, Anne

AU - Sørensen, Henrik Toft

AU - Thuesen, Leif

AU - Kristensen, Steen Dalby

AU - Bøtker, Hans Erik

AU - Krusell, Lars Romer

AU - Lassen, Jens Flensted

AU - Thayssen, Per

AU - Jensen, Lisette Okkels

AU - Tilsted, Hans-Henrik

AU - Maeng, Michael

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

KW - Aged

KW - Coronary Thrombosis

KW - Denmark

KW - Drug Administration Schedule

KW - Drug Prescriptions

KW - Drug-Eluting Stents

KW - Female

KW - Humans

KW - Male

KW - Medication Adherence

KW - Middle Aged

KW - Myocardial Infarction

KW - Percutaneous Coronary Intervention

KW - Platelet Aggregation Inhibitors

KW - Registries

KW - Retrospective Studies

KW - Risk Assessment

KW - Risk Factors

KW - Ticlopidine

KW - Time Factors

KW - Treatment Outcome

UR - https://www.scopus.com/pages/publications/84908075532

U2 - 10.1186/1471-2261-14-100

DO - 10.1186/1471-2261-14-100

M3 - Journal article

C2 - 25125079

SN - 1471-2261

VL - 14

SP - 100

JO - B M C Cardiovascular Disorders

JF - B M C Cardiovascular Disorders

ER -

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

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this