Triple vs. Dual Antiplatelet Therapy in Patients With Acute Myocardial Infarction and Renal Dysfunction - Results From the Korea Acute Myocardial Infarction Registry -

Young Hwan Choi, Sang Heon Suh, Joon Seok Choi, Chang Seong Kim, Doo Sun Sim, Eun Hui Bae, Sang Yeob Lim, Seong Kwon Ma, Myung Ho Jeong, Soo Wan Kim

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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. Methods and Results: As part of the Korea Acute Myocardial Infarction Registry (KAMIR), 2,288 AMI patients with renal dysfunction (glomerular filtration rate <60 ml/min · 1.73m2) 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 inhospital 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. 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.

Original languageEnglish
Pages (from-to)2405-2411
Number of pages7
JournalCirculation Journal
Issue number10
Publication statusPublished - 2012 Oct 30



  • Acute myocardial infarction
  • Cilostazol
  • Glomerular filtration rate
  • Major adverse cardiac event
  • Thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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