What question did this study set out to answer?

To evaluate the incidence of thrombotic events and assess platelet aggregability changes following the cessation of one-year clopidogrel therapy in patients with coronary stents.

January 1, 2011Journal of Pharmacological SciencesOpen Access

Abrupt Cessation of One-Year Clopidogrel Treatment Is Not Associated With Thrombotic Events

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Why the study?

Does abrupt cessation of one-year clopidogrel treatment increase the rate of thrombotic events in patients with implanted coronary stents?

Key Points

To evaluate the incidence of thrombotic events and assess platelet aggregability changes following the cessation of one-year clopidogrel therapy in patients with coronary stents.
Prospective, multicenter study enrolling 200 patients treated with aspirin and clopidogrel for one year following coronary stent implantation.
Platelet aggregation was evaluated using multiple electrode aggregometry (ADP with PGE1, arachidonic acid, and TRAP agonists) on the day of clopidogrel discontinuation and at 10, 45, and 90 days post-cessation.
Patients were monitored for thrombotic events over a 6-month follow-up period.
Two thrombotic events occurred during the 6-month follow-up period (one ischemic stroke and one myocardial infarction), reflecting an overall incidence of 1%.
ADP- and arachidonic acid-induced platelet aggregation values measured 10 to 90 days post-cessation were significantly higher than values obtained before drug discontinuation (P < 0.001 for all).
TRAP-induced platelet aggregation was not influenced by clopidogrel cessation, maintaining a plateau across all measured time points.

Structured PICO

Does abrupt cessation of one-year clopidogrel treatment increase the rate of thrombotic events in patients with implanted coronary stents?

Population

n=200 patients subjected to coronary stent implantation and treated with aspirin + clopidogrel one year after the stent placement

Intervention

Abrupt cessation of clopidogrel therapy after one year of treatment

Outcome

Rate of thrombotic events during 6-months follow up and platelet aggregability (measured by multiple electrode analyzer) at 10, 45, and 90 days after cessationcomposite

Abrupt cessation of clopidogrel after one year in stented patients is associated with a low rate of thrombotic events despite an expected rebound in platelet aggregation.

Discussion

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Implication

Low event rate after clopidogrel cessation should not yet change practice; leaves open rebound effects on longer-term outcomes.

Cite This Study

Djukanović et al. (2011) studied this question.

synapsesocial.com/papers/6a8961eac89a2b4713ec6625 https://doi.org/10.1254/jphs.11076fp

Topics

Dual antiplatelet therapy

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Abrupt Cessation of One-Year Clopidogrel Treatment Is Not Associated With Thrombotic Events

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Abrupt Cessation of One-Year Clopidogrel Treatment Is Not Associated With Thrombotic Events

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider