Comparison of three-year clinical outcomes with nonextended versus extended dual antiplatelet therapy between first- and second-generation drug-eluting stent implantation in patients with acute myocardial infarction: data from the infarct prognosis study registry
Journal of Interventional Cardiology,  Clinical Article

Kang KW et al. – This study suggested that the clinical outcomes between nonextended and extended dual antiplatelet therapy (DAPT) might be different depending on the generation of implanted drug–eluting stent (DES) in patients with acute myocardial infarction (AMI).

Methods
  • Authors identified 790 consecutive patients with AMI who were free from major adverse cardiac events for 12 months after first–generation (n = 537) or second–generation DES (n = 253) implantation; each DES generation group was further divided into nonextended and extended DAPT.

Results
  • During follow–up (median: 40 months), nonextended DAPT in the first–generation DES group showed a higher rate of cardiac death or MI than was observed in the extended DAPT group (14% vs 2%, P < 0.001).
  • However, in the second–generation DES group, there was no difference in the occurrence of cardiac death and MI between the extended and nonextended groups (4% vs 3%, P = 0.809).
  • Nonextended DAPT was the most significant predictor of cardiac death and MI for first–generation DES implantation [hazard ratio (HR) = 5.47, 95% confidence interval (CI) = 1.53–19.59, P = 0.009] but not for second–generation DES implantation [HR = 3.21, 95% CI = 0.21–50.65, P = 0.401].

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