Abstract 12599: Impact of Triple Antiplatelet Therapy on Multivessel Coronary Artery Intervention in Acute Myocardial Infarction Patients

Background:Dual antiplatelet therapy including aspirin and clopidogrel had been indicated for inhibition of platelets activity after percutaneous coronary intervention (PCI) in the setting of acute myocardial infarction (AMI). However, there are limited data concerning the impact of triple antiplatelets (including cilostazol) on short and long term clinical outcomes following multivessel PCI in AMI setting.Methods:A total 314 patients underwent PCI in 2 or more vessels were included. Patients were divided into two groups; 1) dual antiplatelet therapy (N=197) and 2) triple antiplatelet therapy (N=117).Individual and composite major clinical outcomes including major adverse cardiac events (MACE), the composite of total death, myocardial infarction (MI), repeat revascularization and stent thrombosis were compared between the two groups up to 1 year.Results:The baseline clinical characteristics were similar between the two groups except male gender , dyslipidemia and peak CK-MB were higher in triple therapy group. However, male gender was higher in dual therapy group .Triple therapy group had higher incidences of ostial lesions, bifurcation lesions, and left main stenosis. Peak values of troponin T, bleeding complications, and LVEF were similar between the two groups. At 30-day follow up, the incidence of total MACE (HR: 0.960, 95% CI: 0.424 to 2.171; p = 0.921) between triple and dual antiplatelet group were similar. Moreover, at 1-year follow up, the incidence of MACE (HR1.240, 95% CI: 0.776 to 1.981; p = 0.368) not different between the two groups.Conclusion:In this study, triple antiplatelet therapy following multivessel PCI in AMI was associated with reduced risk of adverse clinical outcomes including incidence of cardiac death, revascularization, stent thrombosis, stroke, stent thrmbosis and total MACE as compared with dual antiplatelet therapy despite of worse clinical and angiographic characteristics at 30 days and up to 1 year.