Comparison of Triple Anti-Platelet Therapy and Dual Anti-Platelet Therapy in Patients With Acute Myocardial Infarction Who Had No-Reflow Phenomenon During Percutaneous Coronary Intervention

Title
Comparison of Triple Anti-Platelet Therapy and Dual Anti-Platelet Therapy in Patients With Acute Myocardial Infarction Who Had No-Reflow Phenomenon During Percutaneous Coronary Intervention
Author(s)
김영조이기홍[이기홍]안영균[안영균]김성수[김성수]류시현[류시현]정영욱[정영욱]장수영[장수영]조재영[조재영]조명찬[조명찬]김종진[김종진]
Keywords
ELUTING STENT IMPLANTATION; LONG-TERM OUTCOMES; DIABETIC-PATIENTS; PHOSPHODIESTERASE INHIBITOR; PLATELET-AGGREGATION; SMOOTH-MUSCLE; CILOSTAZOL; REPERFUSION; CLOPIDOGREL; TRIAL
Issue Date
201312
Publisher
JAPANESE CIRCULATION SOC
Citation
CIRCULATION JOURNAL, v.77, no.12, pp.2973 - 2981
Abstract
Background: No-reflow phenomenon is a serious complication of percutaneous coronary intervention (PCI) and associated with poor prognosis. The aim of this study was to determine whether triple anti-platelet therapy could improve clinical outcome in patients with acute myocardial infarction (AMI) who had no-reflow phenomenon during PCI compared with dual anti-platelet therapy. Methods and Results: A total of 727 eligible patients received either dual anti-platelet therapy (aspirin and clopidogrel; dual group, n=532) or triple anti-platelet therapy (aspirin, clopidogrel, and cilostazol; triple group, n=195). The triple group received additional cilostazol for at least 1 month. One-year major adverse cardiac events (MACE) including death, myocardial infarction (MI), target vessel revascularization (TVR) and coronary artery bypass graft (CABG) were evaluated. The triple group had a similar incidence of major bleeding and in-hospital mortality compared with the dual group. At 1 year, the triple group had significantly lower cardiac mortality (17.7% vs. 11.8%, log-rank P=0.039), lower all-cause mortality (19.0% vs. 12.3%, log-rank P=0.035), and lower incidence of composite MACE (25.9% vs. 16.9%, adjusted hazard ratio, 0.50; 95% confidence interval: 0.31-0.80, P=0.004) compared with the dual group with no differences in MI and TVR. Conclusions: Triple anti-platelet therapy seems to be superior to dual anti-platelet therapy in patients with AMI who had no-reflow phenomenon during PCI.
URI
http://hdl.handle.net/YU.REPOSITORY/28081http://dx.doi.org/10.1253/circj.CJ-13-0594
ISSN
1346-9843
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의과대학 > 내과학교실 > Articles
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