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ȣ - 520417 25 |
Triple Versus Dual Antiplatelet Therapy in Diabetic Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stent
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고려대학교 구로병원 순환기내과¹ 전남대학교병원 순환기내과*² |
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 triple antiplatelet strategy is superior or similar to dual antiplatelet strategy in diabetic patients (pts) with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) remains unclear.
Methods:2,074 diabetic pts with AMI underwent PCI with DES received either dual (aspirin plus clopidogrel, Dual group, n=1,220) or triple antiplatelet therapy (aspirin plus clopidogrel plus cilostazol, Triple group, n=854).
Results: Triple group was associated with significantly lower incidence of total death and total MACE up to 8 months compared with Dual group (Table).
Conclusions: The triple antiplatelet therapy appears to be superior to the conventional dual antiplatelet therapy in reducing early mortality and MACE without increasing the major bleeding in diabetic AMI pts undergoing PCI with DES.
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Table: Clinical Outcomes at 7 Days, 1 Month and 6 Months
Variable, n (%) |
Dual group
(n= 1,220 pts) |
Triple group
(n= 854 pts) |
P value |
At 7 days |
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Total death |
69 (5.7) |
16 (1.9) |
<0.001 |
Re-infarction |
3 (0.2) |
1 (0.1) |
0.648 |
Revascularization |
12 (1.0) |
6 (0.7) |
0.497 |
Total MACE |
84 (6.9) |
23 (2.7) |
<0.001 |
TIMI-major bleeding |
8 (0.7) |
4 (0.5) |
0.771 |
At 1 month |
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Total death |
95 (7.8) |
23 (2.7) |
<0.001 |
Re-infarction |
8 (0.7) |
5 (0.6) |
0.845 |
Revascularization |
24 (2.0) |
9 (1.1) |
0.102 |
Total MACE |
127 (10.4) |
37 (4.3) |
<0.001 |
At 8 months |
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Total death |
106 (8.7) |
39 (4.6) |
<0.001 |
Re-infarction |
14 (1.1) |
11 (1.3) |
0.773 |
Revascularization |
62 (5.1) |
36 (4.2) |
0.360 |
Total MACE |
182 (14.9) |
86 (10.0) |
0.001 |
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