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

Research output: Contribution to journalArticle

10 Citations (Scopus)

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. 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
Volume76
Issue number10
DOIs
Publication statusPublished - 2012 Oct 30

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clopidogrel
Korea
Group Psychotherapy
Registries
Myocardial Infarction
Kidney
Percutaneous Coronary Intervention
Aspirin
Disease-Free Survival
Incidence
Therapeutics
Hospital Mortality
Glomerular Filtration Rate
Hemorrhage

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Triple vs. Dual Antiplatelet Therapy in Patients With Acute Myocardial Infarction and Renal Dysfunction - Results From the Korea Acute Myocardial Infarction Registry -. / Choi, Young Hwan; Suh, Sang Heon; Choi, Joon Seok; Kim, Chang Seong; Sim, Doo Sun; Bae, Eun Hui; Lim, Sang Yeob; Ma, Seong Kwon; Jeong, Myung Ho; Kim, Soo Wan.

In: Circulation Journal, Vol. 76, No. 10, 30.10.2012, p. 2405-2411.

Research output: Contribution to journalArticle

Choi, Young Hwan ; Suh, Sang Heon ; Choi, Joon Seok ; Kim, Chang Seong ; Sim, Doo Sun ; Bae, Eun Hui ; Lim, Sang Yeob ; Ma, Seong Kwon ; Jeong, Myung Ho ; Kim, Soo Wan. / Triple vs. Dual Antiplatelet Therapy in Patients With Acute Myocardial Infarction and Renal Dysfunction - Results From the Korea Acute Myocardial Infarction Registry -. In: Circulation Journal. 2012 ; Vol. 76, No. 10. pp. 2405-2411.
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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. 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.",
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AU - Choi, Young Hwan

AU - Suh, Sang Heon

AU - Choi, Joon Seok

AU - Kim, Chang Seong

AU - Sim, Doo Sun

AU - Bae, Eun Hui

AU - Lim, Sang Yeob

AU - Ma, Seong Kwon

AU - Jeong, Myung Ho

AU - Kim, Soo Wan

PY - 2012/10/30

Y1 - 2012/10/30

N2 - 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.

AB - 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.

KW - Acute myocardial infarction

KW - Cilostazol

KW - Glomerular filtration rate

KW - Major adverse cardiac event

KW - Thrombosis

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