Background and Objective: Consistent use of clopidogrel is critical for patient receiving drug-eluting stents (DES) to prevent stent thrombosis in the first six months. However, the influences of premature discontinuation on the risk of long-term clinical outcomes after drug-eluting stent implantation have not yet been addressed. The aim of this study was to determine the percentage of patients who have discontinued antiplatelet agents prematurely and to evaluate their long-term clinical outcomes. Methods: From May 2003 to May 2008, 1,134 (793 men, 66 ± 11 years) consecutive patients with DES implantation in Gangneung Asan Hospital were included. The percentage of patients who have premature-discontinuation (30, 90, 180 and 365 days) of antiplatelet agents (thienopyridine and/or aspirin) and their clinical outcomes (2 years cardiac death) were assessed. Results: Incidences of the patients with discontinuation of thienopyridine were 6.8%, 2.2%, 4.1% and 7.8% less than 30 days, 30 ~ 90, 90 ~ 180, and 180 ~ 365 days, respectively. Patients who discontinued thienopyridine within 180 days had not a significantly higher rate of cardiac death than those who continued thienopyridine. However, patients who discontinued thienopyridine within 90 days had a significantly higher rate of cardiac death than those who continued thienopyridine (p=0.015) (Figures). Conclusion: Premature discontinuation of antiplatelet agents (thienopyridine and/or aspirin) within 3 months was associated with an increased risk of cardiac mortality. However, rate of cardiac death beyond 6 months were similar in both groups.
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