کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5965887 | 1576153 | 2015 | 6 صفحه PDF | دانلود رایگان |
- It is unknown whether discontinuation of both thienopyridine and aspirin could be excess risk for ST long after SES implantation.
- Discontinuation of both antiplatelet agents was associated with an increased incidence of ST after SES implantation.
- Discontinuation of either thienopyridine or aspirin only was not associated with higher incidence of ST.
BackgroundThe influence of antiplatelet therapy discontinuation on the incidence of stent thrombosis, especially very late stent thrombosis, after drug-eluting stent implantation has not been yet fully addressed.MethodsRelationship between antiplatelet therapy discontinuation and stent thrombosis up to 5Â years was evaluated in 12,812 consecutive patients undergoing sirolimus-eluting stents (SES) implantation in the j-Cypher registry. Data on status of antiplatelet therapy during follow-up were collected prospectively.ResultsMedian follow-up interval was 1699Â days (interquartile range, 1184-1928Â days). Incidences of definite stent thrombosis were 0.34% at 30Â days, 0.55% at 1Â year, and 1.6% at 5Â years. Dual antiplatelet therapy was maintained in 97.4%, 63%, and 43.9% of patients at 30Â days, 1Â year, and 5Â years, respectively. The rates of stent thrombosis in patients who discontinued both thienopyridine and aspirin were significantly higher in the time intervals of 31-365Â days, 2-3Â years and 3-4Â years, and tended to be higher in the time intervals of 1-2Â years and 4-5Â years than those in patients who continued both (31-365Â days: 1.26% versus 0.2%, PÂ <Â 0.001; 1-2Â years: 0.59% versus 0.15%, PÂ =Â 0.06; 2-3Â years: 1.35% versus 0.2%, PÂ =Â 0.004; 3-4Â years: 1.09% versus 0.25%, PÂ =Â 0.0496; 4-5Â years: 1.35% versus 0.43%, PÂ =Â 0.17). Patients who discontinued either thienopyridine or aspirin only did not have an excess of stent thrombosis in any time intervals.ConclusionsIn conclusion, discontinuation of both thienopyridine and aspirin, but not discontinuation of thienopyridine or aspirin only, was associated with an increased incidence of late and very late stent thrombosis up to 5Â years after SES implantation.
Journal: International Journal of Cardiology - Volume 199, 15 November 2015, Pages 296-301