Efficacy and safety of antiplatelet-combination therapy after drug-eluting stent implantation

Title
Efficacy and safety of antiplatelet-combination therapy after drug-eluting stent implantation
Author(s)
김웅조연경[조연경]남창욱[남창욱]박종선박형섭[박형섭]윤혁준[윤혁준]김형섭[김형섭]허승호[허승호]김윤년[김윤년]이장훈[이장훈]
Keywords
PERCUTANEOUS CORONARY INTERVENTION; CLOPIDOGREL PLATELET REACTIVITY; VERIFYNOW P2Y12 ASSAY; MYOCARDIAL-INFARCTION; CLINICAL-OUTCOMES; METAANALYSIS; GUIDELINES; THROMBOSIS; ADHERENCE; TRIAL
Issue Date
201403
Publisher
KOREAN ASSOC INTERNAL MEDICINE
Citation
KOREAN JOURNAL OF INTERNAL MEDICINE, v.29, no.2, pp.210 - 216
Abstract
Background/Aims: Combination single-pill therapy can improve cost-effectiveness in a typical medical therapy. However, there is a little evidence about the efficacy and tolerability of combination single-pill antiplatelet therapy after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: From June to November 2012, in total, 142 patients who met the following criteria were enrolled: at least 18 years old; successful PCI with DES at least 3 months earlier; and regular medication of aspirin and clopidogrel with no side effects. After VerifyNow P2Y12 and aspirin assays, the combination single pill of aspirin and clopidogrel was given and laboratory tests were repeated 6 weeks later. Results: At baseline, the incidence of aspirin resistance, defined as aspirin reaction unit (ARU) >= 550, was 9.2%, that of clopidogrel resistance, defined as P2Y12 reaction unit (PRU) >= 230, was 46.5%, and that of percent inhibition of PRU < 20% was 32.4%. At follow-up, the incidence of resistance by ARU value was 7.0%, 50.0% by PRU value, and 35.9% by percentage inhibition of PRU, respectively. The mean values of ARU (431.5 +/- 63.6 VS. 439.8 +/- 55.2; p = 0.216) and PRU (227.5 +/- 71.4 VS. 223.3 +/- 76.0; p = 0.350) were not significantly different before versus after antiplatelet-combination single-pill therapy. Five adverse events (3.5%) were observed during the study period. Conclusions: Combination single-pill antiplatelet therapy, which may reduce daily pill burden for patients after PCI with DES, demonstrated similar efficacy to separate dual-pill antiplatelet therapy.
URI
http://hdl.handle.net/YU.REPOSITORY/32911http://dx.doi.org/10.3904/kjim.2014.29.2.210
ISSN
1226-3303
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의과대학 > 내과학교실 > Articles
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