TY - JOUR
T1 - Association of mortality with antiplatelet treatment in patients with stent placement or angioplasty
T2 - A population-based nested case-control study
AU - Woo, Ho Geol
AU - Lee, Hye Ah
AU - Ryu, Dong Ryeol
AU - Song, Tae Jin
N1 - Publisher Copyright:
© Yonsei University College of Medicine 2021.
PY - 2021/1
Y1 - 2021/1
N2 - Purpose: Antiplatelet drugs are essential in patients with cardiovascular disease who undergo stent placement. We hypothesized that risks of mortality would differ according to adherence to antiplatelet agents, number of antiplatelet agents, and antiplatelet regimens in patients undergoing stent placement or angioplasty. Materials and Methods: Between 2002 and 2013, we initially enrolled 8671 subjects who underwent stent placement or angioplasty in the National Health Insurance Service-National Sample Cohort in Korea. Using the International Classification of Dis-eases, 10th revision, the incidence of all-cause death, including cardiovascular disease, cerebrovascular disease, and cancer, was defined. Using a nested case-control study design, controls were matched to cases at a ratio of 4:1, and a total of 5415 subjects were eligible for this study. Results: During a median follow-up period of 3.51 years, the incidence rate of all-cause death was 40 per 1000 person-years. We found that adherence to antiplatelet monotherapy significantly decreased risk of death by cerebro-cardiovascular disease, compared with discontinuation of antiplatelets [adjusted odds ratio (OR) 0.62, 95% confidence interval (CI) (0.41–0.96)]. Compared with dual antiplatelet therapy (DAPT), aspirin and clopidogrel monotherapy significantly reduced death by cerebro-cardiovascu-lar disease [adjusted OR 0.65, 95% CI (0.44–0.95) and adjusted OR 0.58, 95% CI (0.35–0.96), respectively]. There was no significant difference of mortality between aspirin monotherapy and clopidogrel monotherapy. Conclusion: Our study demonstrated that adherence to antiplatelet therapy and antiplatelet monotherapy, compared with DAPT, in patients with stent placement or angioplasty may have a beneficial effect on mortality in cerebro-cardiovascular disease.
AB - Purpose: Antiplatelet drugs are essential in patients with cardiovascular disease who undergo stent placement. We hypothesized that risks of mortality would differ according to adherence to antiplatelet agents, number of antiplatelet agents, and antiplatelet regimens in patients undergoing stent placement or angioplasty. Materials and Methods: Between 2002 and 2013, we initially enrolled 8671 subjects who underwent stent placement or angioplasty in the National Health Insurance Service-National Sample Cohort in Korea. Using the International Classification of Dis-eases, 10th revision, the incidence of all-cause death, including cardiovascular disease, cerebrovascular disease, and cancer, was defined. Using a nested case-control study design, controls were matched to cases at a ratio of 4:1, and a total of 5415 subjects were eligible for this study. Results: During a median follow-up period of 3.51 years, the incidence rate of all-cause death was 40 per 1000 person-years. We found that adherence to antiplatelet monotherapy significantly decreased risk of death by cerebro-cardiovascular disease, compared with discontinuation of antiplatelets [adjusted odds ratio (OR) 0.62, 95% confidence interval (CI) (0.41–0.96)]. Compared with dual antiplatelet therapy (DAPT), aspirin and clopidogrel monotherapy significantly reduced death by cerebro-cardiovascu-lar disease [adjusted OR 0.65, 95% CI (0.44–0.95) and adjusted OR 0.58, 95% CI (0.35–0.96), respectively]. There was no significant difference of mortality between aspirin monotherapy and clopidogrel monotherapy. Conclusion: Our study demonstrated that adherence to antiplatelet therapy and antiplatelet monotherapy, compared with DAPT, in patients with stent placement or angioplasty may have a beneficial effect on mortality in cerebro-cardiovascular disease.
KW - Antiplatelet
KW - Mortality
KW - Stent
UR - http://www.scopus.com/inward/record.url?scp=85099252781&partnerID=8YFLogxK
U2 - 10.3349/ymj.2021.62.1.75
DO - 10.3349/ymj.2021.62.1.75
M3 - Article
C2 - 33381937
AN - SCOPUS:85099252781
SN - 0513-5796
VL - 62
SP - 75
EP - 85
JO - Yonsei Medical Journal
JF - Yonsei Medical Journal
IS - 1
ER -