Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study

Rikke Sorensen; Steen Z Abildstrom; Peter Weeke; Emil L Fosbol; Fredrik Folke; Morten L Hansen; Peter R Hansen; Jan K Madsen; Ulrik Abildgaard; Lars Valeur Køber; Henrik E Poulsen; Christian Torp-Pedersen; Gunnar H Gislason; Rikke Sørensen; Steen Z Abildstrom; Peter Weeke; Emil L Fosbøl; Fredrik Folke; Morten L Hansen; Peter R Hansen; Jan K Madsen; Ulrik Abildgaard; Lars Køber; Henrik E Poulsen; Christian Torp-Pedersen; Gunnar H Gislason

doi:10.1186/1471-2261-10-6

Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study

Rikke Sorensen, Steen Z Abildstrom, Peter Weeke, Emil L Fosbol, Fredrik Folke, Morten L Hansen, Peter R Hansen, Jan K Madsen, Ulrik Abildgaard, Lars Valeur Køber, Henrik E Poulsen, Christian Torp-Pedersen, Gunnar H Gislason, Rikke Sørensen, Steen Z Abildstrom, Peter Weeke, Emil L Fosbøl, Fredrik Folke, Morten L Hansen, Peter R HansenJan K Madsen, Ulrik Abildgaard, Lars Køber, Henrik E Poulsen, Christian Torp-Pedersen, Gunnar H Gislason

7 Citations (Scopus)

Abstract

Background: The optimal duration of clopidogrel treatment after percutaneous coronary intervention (PCI) is unclear. We studied the risk of death or recurrent myocardial infarction (MI) in relation to 6- and 12-months clopidogrel treatment among MI patients treated with PCI.Methods: Using nationwide registers of hospitalizations and drug dispensing from pharmacies we identified 11 680 patients admitted with MI, treated with PCI and clopidogrel. Clopidogrel treatment was categorized in a 6-months and a 12-months regimen. Rates of death, recurrent MI or a combination of both were analyzed by the Kaplan Meier method and Cox proportional hazards models. Bleedings were compared between treatment regimens.Results: The Kaplan Meier analysis indicated no benefit of the 12-months regimen compared with the 6-months in all endpoints. The Cox proportional hazards analysis confirmed these findings with hazard ratios for the 12-months regimen (the 6-months regimen used as reference) for the composite endpoint of 1.01 (confidence intervals 0.81-1.26) and 1.24 (confidence intervals 0.95-1.62) for Day 0-179 and Day 180-540 after discharge. Bleedings occurred in 3.5% and 4.1% of the patients in the 6-months and 12-months regimen (p = 0.06).Conclusions: We found comparable rates of death and recurrent MI in patients treated with 6- and 12-months' clopidogrel. The potential benefit of prolonged clopidogrel treatment in a real-life setting remains uncertain.

Original language	English
Journal	BMC Cardiovascular Disorders
Volume	10
Pages (from-to)	6
ISSN	1471-2261
DOIs	https://doi.org/10.1186/1471-2261-10-6 https://doi.org/10.1186/1471-2261-10-6
Publication status	Published - 29 Jan 2010

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Sorensen, R., Abildstrom, S. Z., Weeke, P., Fosbol, E. L., Folke, F., Hansen, M. L., Hansen, P. R., Madsen, J. K., Abildgaard, U., Køber, L. V., Poulsen, H. E., Torp-Pedersen, C., Gislason, G. H., Sørensen, R., Abildstrom, S. Z., Weeke, P., Fosbøl, E. L., Folke, F., Hansen, M. L., ... Gislason, G. H. (2010). Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study. BMC Cardiovascular Disorders, 10, 6. https://doi.org/10.1186/1471-2261-10-6, https://doi.org/10.1186/1471-2261-10-6

Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study. / Sorensen, Rikke; Abildstrom, Steen Z; Weeke, Peter et al.
In: BMC Cardiovascular Disorders, Vol. 10, 29.01.2010, p. 6.

Research output: Contribution to journal › Journal article › Research › peer-review

Sorensen, R, Abildstrom, SZ, Weeke, P, Fosbol, EL, Folke, F, Hansen, ML, Hansen, PR, Madsen, JK, Abildgaard, U, Køber, LV , Poulsen, HE , Torp-Pedersen, C , Gislason, GH, Sørensen, R, Abildstrom, SZ, Weeke, P, Fosbøl, EL, Folke, F, Hansen, ML, Hansen, PR, Madsen, JK, Abildgaard, U, Køber, L , Poulsen, HE , Torp-Pedersen, C & Gislason, GH 2010, 'Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study', BMC Cardiovascular Disorders, vol. 10, pp. 6. https://doi.org/10.1186/1471-2261-10-6, https://doi.org/10.1186/1471-2261-10-6

Sorensen R, Abildstrom SZ, Weeke P, Fosbol EL, Folke F, Hansen ML et al. Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study. BMC Cardiovascular Disorders. 2010 Jan 29;10:6. doi: 10.1186/1471-2261-10-6, 10.1186/1471-2261-10-6

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title = "Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study",

abstract = "Background: The optimal duration of clopidogrel treatment after percutaneous coronary intervention (PCI) is unclear. We studied the risk of death or recurrent myocardial infarction (MI) in relation to 6- and 12-months clopidogrel treatment among MI patients treated with PCI.Methods: Using nationwide registers of hospitalizations and drug dispensing from pharmacies we identified 11 680 patients admitted with MI, treated with PCI and clopidogrel. Clopidogrel treatment was categorized in a 6-months and a 12-months regimen. Rates of death, recurrent MI or a combination of both were analyzed by the Kaplan Meier method and Cox proportional hazards models. Bleedings were compared between treatment regimens.Results: The Kaplan Meier analysis indicated no benefit of the 12-months regimen compared with the 6-months in all endpoints. The Cox proportional hazards analysis confirmed these findings with hazard ratios for the 12-months regimen (the 6-months regimen used as reference) for the composite endpoint of 1.01 (confidence intervals 0.81-1.26) and 1.24 (confidence intervals 0.95-1.62) for Day 0-179 and Day 180-540 after discharge. Bleedings occurred in 3.5% and 4.1% of the patients in the 6-months and 12-months regimen (p = 0.06).Conclusions: We found comparable rates of death and recurrent MI in patients treated with 6- and 12-months' clopidogrel. The potential benefit of prolonged clopidogrel treatment in a real-life setting remains uncertain.",

author = "Rikke Sorensen and Abildstrom, {Steen Z} and Peter Weeke and Fosbol, {Emil L} and Fredrik Folke and Hansen, {Morten L} and Hansen, {Peter R} and Madsen, {Jan K} and Ulrik Abildgaard and K{\o}ber, {Lars Valeur} and Poulsen, {Henrik E} and Christian Torp-Pedersen and Gislason, {Gunnar H} and Rikke S{\o}rensen and Abildstrom, {Steen Z} and Peter Weeke and Fosb{\o}l, {Emil L} and Fredrik Folke and Hansen, {Morten L} and Hansen, {Peter R} and Madsen, {Jan K} and Ulrik Abildgaard and Lars K{\o}ber and Poulsen, {Henrik E} and Christian Torp-Pedersen and Gislason, {Gunnar H}",

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TY - JOUR

T1 - Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study

AU - Sorensen, Rikke

AU - Abildstrom, Steen Z

AU - Weeke, Peter

AU - Fosbol, Emil L

AU - Folke, Fredrik

AU - Hansen, Morten L

AU - Hansen, Peter R

AU - Madsen, Jan K

AU - Abildgaard, Ulrik

AU - Køber, Lars Valeur

AU - Poulsen, Henrik E

AU - Torp-Pedersen, Christian

AU - Gislason, Gunnar H

AU - Sørensen, Rikke

AU - Abildstrom, Steen Z

AU - Weeke, Peter

AU - Fosbøl, Emil L

AU - Folke, Fredrik

AU - Hansen, Morten L

AU - Hansen, Peter R

AU - Madsen, Jan K

AU - Abildgaard, Ulrik

AU - Køber, Lars

AU - Poulsen, Henrik E

AU - Torp-Pedersen, Christian

AU - Gislason, Gunnar H

PY - 2010/1/29

Y1 - 2010/1/29

N2 - Background: The optimal duration of clopidogrel treatment after percutaneous coronary intervention (PCI) is unclear. We studied the risk of death or recurrent myocardial infarction (MI) in relation to 6- and 12-months clopidogrel treatment among MI patients treated with PCI.Methods: Using nationwide registers of hospitalizations and drug dispensing from pharmacies we identified 11 680 patients admitted with MI, treated with PCI and clopidogrel. Clopidogrel treatment was categorized in a 6-months and a 12-months regimen. Rates of death, recurrent MI or a combination of both were analyzed by the Kaplan Meier method and Cox proportional hazards models. Bleedings were compared between treatment regimens.Results: The Kaplan Meier analysis indicated no benefit of the 12-months regimen compared with the 6-months in all endpoints. The Cox proportional hazards analysis confirmed these findings with hazard ratios for the 12-months regimen (the 6-months regimen used as reference) for the composite endpoint of 1.01 (confidence intervals 0.81-1.26) and 1.24 (confidence intervals 0.95-1.62) for Day 0-179 and Day 180-540 after discharge. Bleedings occurred in 3.5% and 4.1% of the patients in the 6-months and 12-months regimen (p = 0.06).Conclusions: We found comparable rates of death and recurrent MI in patients treated with 6- and 12-months' clopidogrel. The potential benefit of prolonged clopidogrel treatment in a real-life setting remains uncertain.

AB - Background: The optimal duration of clopidogrel treatment after percutaneous coronary intervention (PCI) is unclear. We studied the risk of death or recurrent myocardial infarction (MI) in relation to 6- and 12-months clopidogrel treatment among MI patients treated with PCI.Methods: Using nationwide registers of hospitalizations and drug dispensing from pharmacies we identified 11 680 patients admitted with MI, treated with PCI and clopidogrel. Clopidogrel treatment was categorized in a 6-months and a 12-months regimen. Rates of death, recurrent MI or a combination of both were analyzed by the Kaplan Meier method and Cox proportional hazards models. Bleedings were compared between treatment regimens.Results: The Kaplan Meier analysis indicated no benefit of the 12-months regimen compared with the 6-months in all endpoints. The Cox proportional hazards analysis confirmed these findings with hazard ratios for the 12-months regimen (the 6-months regimen used as reference) for the composite endpoint of 1.01 (confidence intervals 0.81-1.26) and 1.24 (confidence intervals 0.95-1.62) for Day 0-179 and Day 180-540 after discharge. Bleedings occurred in 3.5% and 4.1% of the patients in the 6-months and 12-months regimen (p = 0.06).Conclusions: We found comparable rates of death and recurrent MI in patients treated with 6- and 12-months' clopidogrel. The potential benefit of prolonged clopidogrel treatment in a real-life setting remains uncertain.

U2 - 10.1186/1471-2261-10-6

DO - 10.1186/1471-2261-10-6

M3 - Journal article

C2 - 20113477

SN - 1471-2261

VL - 10

SP - 6

JO - BMC Cardiovascular Disorders

JF - BMC Cardiovascular Disorders

ER -