TY - JOUR

T1 - 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

AU - Sorensen, Rikke

AU - Abildstrom, Steen Z

AU - Weeke, Peter

AU - Fosbol, Emil L

AU - Folke, Fredrik

AU - Hansen, Morten L

AU - Hansen, Peter R

AU - Madsen, Jan K

AU - Abildgaard, Ulrik

AU - Køber, Lars Valeur

AU - Poulsen, Henrik E

AU - Torp-Pedersen, Christian

AU - Gislason, Gunnar H

AU - Sørensen, Rikke

AU - Abildstrom, Steen Z

AU - Weeke, Peter

AU - Fosbøl, Emil L

AU - Folke, Fredrik

AU - Hansen, Morten L

AU - Hansen, Peter R

AU - Madsen, Jan K

AU - Abildgaard, Ulrik

AU - Køber, Lars

AU - Poulsen, Henrik E

AU - Torp-Pedersen, Christian

AU - Gislason, Gunnar H

PY - 2010/1/1

Y1 - 2010/1/1

N2 - ABSTRACT: BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

AB - ABSTRACT: BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

U2 - 10.1186/1471-2261-10-6

DO - 10.1186/1471-2261-10-6

M3 - Journal article

C2 - 20113477

VL - 10

SP - 6

JO - B M C Cardiovascular Disorders

JF - B M C Cardiovascular Disorders

SN - 1471-2261

ER -