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Triple vs. dual antiplatelet therapy in patients with acute myocardial infarction and renal dysfunction.
- Source :
-
Circulation journal : official journal of the Japanese Circulation Society [Circ J] 2012; Vol. 76 (10), pp. 2405-11. Date of Electronic Publication: 2012 Jul 03. - Publication Year :
- 2012
-
Abstract
- Background: The question as to whether triple antiplatelet therapy is superior to dual antiplatelet therapy for patients with acute myocardial infarction (AMI) and renal dysfunction, who undergo percutaneous coronary intervention (PCI), is unresolved.<br />Methods and Results: As part of the Korea Acute Myocardial Infarction Registry (KAMIR), 2,288 AMI patients with renal dysfunction (glomerular filtration rate <60ml/min·1.73m(2)) received either dual (aspirin plus clopidogrel; n=1,587) or triple (aspirin plus clopidogrel and cilostazol; n=701) antiplatelet therapy. Major adverse cardiac events (MACE) at 1 month and 1 year were compared between these 2 groups. On comparison with the dual therapy group, the triple therapy group had a similar incidence of major bleeding events but a significantly lower incidence of in-hospital mortality. The MACE rate at 1 month was significantly higher for the dual therapy group than for the triple therapy group (16.3% vs. 11.1%, P<0.05), and this difference was mainly attributed to death rather than repeat PCI (12.9% vs. 9.1%, P<0.05). The MACE rate at 1 year and the MACE-free survival time, however, did not differ between the groups.<br />Conclusions: In AMI patients with renal dysfunction, triple antiplatelet therapy has a favorable in-hospital and short-term MACE impact, but it does not have an impact on the 1-year MACE-free survival.
- Subjects :
- Aged
Aged, 80 and over
Aspirin adverse effects
Cilostazol
Clopidogrel
Disease-Free Survival
Drug Therapy, Combination
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors adverse effects
Survival Rate
Tetrazoles adverse effects
Ticlopidine administration & dosage
Ticlopidine adverse effects
Aspirin administration & dosage
Kidney Diseases complications
Kidney Diseases mortality
Kidney Diseases physiopathology
Kidney Diseases therapy
Myocardial Infarction complications
Myocardial Infarction mortality
Myocardial Infarction physiopathology
Myocardial Infarction therapy
Platelet Aggregation Inhibitors administration & dosage
Tetrazoles administration & dosage
Ticlopidine analogs & derivatives
Subjects
Details
- Language :
- English
- ISSN :
- 1347-4820
- Volume :
- 76
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Circulation journal : official journal of the Japanese Circulation Society
- Publication Type :
- Academic Journal
- Accession number :
- 22785460
- Full Text :
- https://doi.org/10.1253/circj.cj-12-0236