BACKGROUND AND OBJECTIVES: Triple anti-platelet therapy is known to prevent restenosis after drug-eluting stent (DES) implantation. However, there is little available data concerning the efficacy of triple anti-platelet therapy for acute myocardial infarction (AMI). SUBJECTS AND METHODS: We analyzed 528 consecutive patients with AMI undergoing DES implantation between Nov 2005 and Apr 2008. We compared clinical outcomes in the triple anti-platelet therapy (group I, n=413: cilostazol combined with aspirin and clopidogrel for at least one month) and dual antiplatelet therapy groups (group II, n=115: aspirin and clopidogrel). RESULTS: There were no significant differences in baseline characteristics. However, ST elevation myocardial infarction (STEMI) and use of TAXUS(R) stents were more common (70.9% vs. 55.7%, p=0.002; 83.5% vs. 73.0%, p=0.011) in Group I. Group I had lower incidences of cardiac death, 6-month target lesion revascularization (TLR), and major adverse cardiac and cerebrovascular events (MACCE) compared to Group II (1.7% vs. 5.7%, p=0.022; 5.7% vs. 11.5%, 0.035; 7.9% vs. 16.0%, p=0.011). On subgroup analysis, the incidence of 6-month TLR was lower among patients with American College of Cardiology/American Heart Association (ACC/AHA) B2 or C lesions and non-STEMI (6.0% vs. 14.9%, p=0.012; 4.3% vs. 19.1%, p=0.002) in Group I compared to those in Group II. The rates of bleeding complications were no different between the two groups. On multivariate analysis, Killip III or IV and triple anti-platelet therapy were independent predictors of 6-month MACCE {hazard ratio (HR)=3.382; 95% confidence interval (CI)=1.384-8.262, HR=0.436; 95% CI=0.203-0.933}. CONCLUSION: Triple anti-platelet therapy is safe and efficacious, and it prevents TLR in patients with AMI, especially those with complex lesions and non-STEMIs.
BACKGROUND AND OBJECTIVES: Triple anti-platelet therapy is known to prevent restenosis after drug-eluting stent (DES) implantation. However, there is little available data concerning the efficacy of triple anti-platelet therapy for acute myocardial infarction (AMI). SUBJECTS AND METHODS: We analyzed 528 consecutive patients with AMI undergoing DES implantation between Nov 2005 and Apr 2008. We compared clinical outcomes in the triple anti-platelet therapy (group I, n=413: cilostazol combined with aspirin and clopidogrel for at least one month) and dual antiplatelet therapy groups (group II, n=115: aspirin and clopidogrel). RESULTS: There were no significant differences in baseline characteristics. However, ST elevation myocardial infarction (STEMI) and use of TAXUS(R) stents were more common (70.9% vs. 55.7%, p=0.002; 83.5% vs. 73.0%, p=0.011) in Group I. Group I had lower incidences of cardiac death, 6-month target lesion revascularization (TLR), and major adverse cardiac and cerebrovascular events (MACCE) compared to Group II (1.7% vs. 5.7%, p=0.022; 5.7% vs. 11.5%, 0.035; 7.9% vs. 16.0%, p=0.011). On subgroup analysis, the incidence of 6-month TLR was lower among patients with American College of Cardiology/American Heart Association (ACC/AHA) B2 or C lesions and non-STEMI (6.0% vs. 14.9%, p=0.012; 4.3% vs. 19.1%, p=0.002) in Group I compared to those in Group II. The rates of bleeding complications were no different between the two groups. On multivariate analysis, Killip III or IV and triple anti-platelet therapy were independent predictors of 6-month MACCE {hazard ratio (HR)=3.382; 95% confidence interval (CI)=1.384-8.262, HR=0.436; 95% CI=0.203-0.933}. CONCLUSION: Triple anti-platelet therapy is safe and efficacious, and it prevents TLR in patients with AMI, especially those with complex lesions and non-STEMIs.
Authors: Gregg W Stone; Jeffrey W Moses; Stephen G Ellis; Joachim Schofer; Keith D Dawkins; Marie-Claude Morice; Antonio Colombo; Erick Schampaert; Eberhard Grube; Ajay J Kirtane; Donald E Cutlip; Martin Fahy; Stuart J Pocock; Roxana Mehran; Martin B Leon Journal: N Engl J Med Date: 2007-02-12 Impact factor: 91.245
Authors: Laura Mauri; Treacy S Silbaugh; Pallav Garg; Robert E Wolf; Katya Zelevinsky; Ann Lovett; Manu R Varma; Zheng Zhou; Sharon-Lise T Normand Journal: N Engl J Med Date: 2008-09-25 Impact factor: 91.245
Authors: Sang Rok Lee; Myung Ho Jeong; Young Keun Ahn; Shung Chull Chae; Seung Ho Hur; Young Jo Kim; In Whan Seong; Jei Keon Chae; Taek Jong Hong; Jae Young Rhew; Myeong Chan Cho; Jang Ho Bae; Seung Woon Rha; Chong Jin Kim; Yang Soo Jang; Seung Jung Park Journal: Circ J Date: 2008-03 Impact factor: 2.993
Authors: Vincenzo Pasceri; Giuseppe Patti; Giulio Speciale; Christian Pristipino; Giuseppe Richichi; Germano Di Sciascio Journal: Am Heart J Date: 2007-05 Impact factor: 4.749
Authors: Weon Kim; Myung Ho Jeong; Kye Hun Kim; Il Suk Sohn; Young Joon Hong; Hyung Wook Park; Ju Han Kim; Young Keun Ahn; Jeong Gwan Cho; Jong Chun Park; Dong Lyun Cho; Jung Chae Kang Journal: J Am Coll Cardiol Date: 2006-02-09 Impact factor: 24.094
Authors: Gaku Nakazawa; Aloke V Finn; Michael Joner; Elena Ladich; Robert Kutys; Erik K Mont; Herman K Gold; Allen P Burke; Frank D Kolodgie; Renu Virmani Journal: Circulation Date: 2008-08-25 Impact factor: 29.690