Triple Versus Dual Antiplatelet Therapy in Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Key result
Triple antiplatelet therapy was associated with a lower incidence of total major adverse cardiac events at 8 months compared to dual therapy (adjusted OR 0.74; 95% CI 0.58-0.95; P=0.019).
Why the study?
Does triple antiplatelet therapy (aspirin, clopidogrel, and cilostazol) reduce major adverse cardiac events compared to dual antiplatelet therapy in patients with STEMI undergoing primary PCI with drug-eluting stents?
Population
4,203 patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous…
Comparison
Triple antiplatelet therapy, with cilostazol… vs Dual antiplatelet therapy.
Design
Cohort
Follow-up
8 months
Authors
Discussion
Loading...
Member takes
Implication
May support cilostazol addition in STEMI; leaves open need for randomized confirmation before practice change.
Study Design
Type
Cohort (n=4,203)
Multicenter
Yes
Structured PICO
Does triple antiplatelet therapy (aspirin, clopidogrel, and cilostazol) reduce major adverse cardiac events compared to dual antiplatelet therapy in patients with STEMI undergoing primary PCI with drug-eluting stents?
P
Population
4,203 patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with drug-eluting stents, followed for 8 months.
E
Exposure
Triple antiplatelet therapy (aspirin plus clopidogrel plus cilostazol), with cilostazol administered for at least 1 month.
C
Comparator
Dual antiplatelet therapy (aspirin plus clopidogrel).
O
Outcome
Total major adverse cardiac events at 8 months.composite
Main Result
Odds Ratio: 0.74 (95% CI 0.58–0.95)
p-value: p=0.019
In patients with STEMI undergoing primary PCI with drug-eluting stents, adding cilostazol to aspirin and clopidogrel for at least 1 month significantly reduced mortality and MACE at 8 months without increasing major bleeding.
Cite This Study
Chen et al. (2009) conducted a cohort in Acute ST-segment elevation myocardial infarction (n=4,203). Triple antiplatelet therapy (aspirin plus clopidogrel plus cilostazol) vs. Dual antiplatelet therapy (aspirin plus clopidogrel) was evaluated on Total major adverse cardiac events (OR 0.74, 95% CI 0.58-0.95, p=0.019). Triple antiplatelet therapy was associated with a lower incidence of total major adverse cardiac events at 8 months compared to dual therapy (adjusted OR 0.74; 95% CI 0.58-0.95; P=0.019).