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ȣ - 520407 21 |
Triple versus Dual Antiplatelet Therapy in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention |
고려대학교 구로병원 순환기내과¹ 전남대학교병원 순환기내과² |
Kang-Yin Chen, 나승운, Yong-Jian Li, Kanhaiya L. Poddar, Zhe Jin, Yoshiyasu Minami, 박재형, 나진오, 최철웅, 임홍의, 김진원, 김응주, 박창규, 서홍석, 오동주, 안영근* 정명호 |
Background: Whether the safety and efficacy of triple antiplatelet strategy is superior or similar to the dual antiplatelet strategy in patients (pts) with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) is still unclear.
Methods: A total of 4,892 AMI pts undergoing PCI received either dual antiplatelet therapy (aspirin plus clopidogrel, Dual group, n=2,974) or triple antiplatelet therapy (aspirin plus clopidogrel plus cilostazol, n=1,918) .
Results: The baseline characteristics were similar between the two groups. The early mortality and revascularization rate were lower in Triple group up to one month and all MACE was significantly in 8 months. Interestingly, lower in-hospital bleeding events might be due to less pts with peptic ulcer disease (0.4% vs. 0.9%, P=0.034).
Conclusions: Triple antiplatelet therapy appears to be superior in preventing the MACE without increasing the major bleeding events in pts with AMI undergoing PCI compared with the conventional dual antiplatelet therapy.
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Variables, n (%) |
Dual group
(n=2,974 pts) |
Triple group
(n= 1,918 pts) |
P value |
In-hospital |
|
|
|
Total death |
89 (3.0) |
34 (1.8) |
0.008 |
Revascularization |
41 (1.4) |
12 (0.6) |
0.013 |
All MACE |
142 (4.8) |
55 (2.9) |
0.001 |
TIMI-major bleeding |
12 (0.6) |
3 (0.2) |
0.023 |
At 1 month |
|
|
|
Total death |
106 (3.7) |
50 (2.7) |
0.046 |
Revascularization |
71 (2.5) |
26 (1.4) |
0.008 |
All MACE |
202 (7.1) |
86 (4.6) |
0.001 |
At 8 months |
|
|
|
Total death |
124 (4.3) |
65 (3.5) |
0.147 |
Revascularization |
150 (5.2) |
75 (4.0) |
0.055 |
All MACE |
308 (10.7) |
153 (8.2) |
0.004 |
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