Email updates

Keep up to date with the latest news and content from BMC Cardiovascular Disorders and BioMed Central.

Open Access Highly Accessed Research article

Clopidogrel discontinuation within the first year after coronary drug-eluting stent implantation: an observational study

Troels Thim1, Martin Berg Johansen2, Gro Egholm Chisholm1, Morten Schmidt2, Anne Kaltoft1, Henrik Toft Sørensen2, Leif Thuesen1, Steen Dalby Kristensen1, Hans Erik Bøtker2, Lars Romer Krusell1, Jens Flensted Lassen1, Per Thayssen3, Lisette Okkels Jensen3, Hans-Henrik Tilsted4 and Michael Maeng1*

Author Affiliations

1 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

2 Department of Clinical Epidemiology, Aarhus University Hospital, Brendstrupgaardsvej 100, Aarhus, N 8200, Denmark

3 Department of Cardiology, Odense University Hospital, Odense, Denmark

4 Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark

For all author emails, please log on.

BMC Cardiovascular Disorders 2014, 14:100  doi:10.1186/1471-2261-14-100

Published: 13 August 2014

Abstract

Background

The impact of adherence to the recommended duration of dual antiplatelet therapy after first generation drug-eluting stent implantation is difficult to assess in real-world settings and limited data are available.

Methods

We followed 4,154 patients treated with coronary drug-eluting stents in Western Denmark for 1 year and obtained data on redeemed clopidogrel prescriptions and major adverse cardiovascular events (MACE, i.e., cardiac death, myocardial infarction, or stent thrombosis) from medical databases.

Results

Discontinuation of clopidogrel within the first 3 months after stent implantation was associated with a significantly increased rate of MACE at 1-year follow-up (hazard ratio (HR) 2.06; 95% confidence interval (CI): 1.08-3.93). Discontinuation 3-6 months (HR 1.29; 95% CI: 0.70-2.41) and 6-12 months (HR 1.29; 95% CI: 0.54-3.07) after stent implantation were associated with smaller, not statistically significant, increases in MACE rates. Among patients who discontinued clopidogrel, MACE rates were highest within the first 2 months after discontinuation.

Conclusions

Discontinuation of clopidogrel was associated with an increased rate of MACE among patients treated with drug-eluting stents. The increase was statistically significant within the first 3 months after drug-eluting stent implantation but not after 3 to 12 months.

Keywords:
Percutaneous coronary intervention; Dual antiplatelet therapy; Drug-eluting stent; Clopidogrel