The optimal duration of clopidogrel administration after percutaneous coronary intervention
(PCI) remains unknown. Clopidogrel is currently recommended for minimums of 1 and
12 months after bare-metal stent and drug-eluting stent implantation, respectively.
To determine the impact of clopidogrel discontinuation 1 year after PCI, the outcomes
of 530 consecutive patients who underwent PCI from January 2004 to July 2006, were
free of cardiovascular events for 6 months after PCI, and had follow-up available
for >12 months were examined. The outcomes of patients who received clopidogrel for
≥1 year were compared with those of patients who received it for <1 year. The mean
age was 65 ± 9 years. Patients often presented with acute coronary syndromes (57%),
and 85% received drug-eluting stents. Clopidogrel was used for ≥1 year and for <1
year in 341 and 189 patients, respectively. During a mean follow-up period of 2.4
± 0.8 years, 40 patients (8%) died, 21 (4%) had acute myocardial infarctions, and
89 (17%) underwent repeat coronary revascularization. Compared with patients with
clopidogrel administration for <1 year after PCI, those who received clopidogrel for
≥1 year had lower mortality (14.8% vs 3.5%, p <0.001). On multivariate analysis, clopidogrel
use for ≥1 year was associated with lower mortality (hazard ratio 0.28, 95% confidence
interval 0.14 to 0.59), independent of traditional cardiovascular risk factors, clinical
presentation, and the use of drug-eluting stents. In conclusion, the use of clopidogrel
for ≥1 year after PCI was associated with lower mortality.
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Article info
Publication history
Published online: September 15, 2008
Accepted:
June 20,
2008
Received in revised form:
June 20,
2008
Received:
May 6,
2008
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
