Outcome of Triple Antiplatelet Therapy Including Cilostazol in Elderly Patients with ST-Elevation Myocardial Infarction who Underwent Primary Percutaneous Coronary Intervention: Results from the INTERSTELLAR Registry
- Authors
- Jang, Ho-Jun; Park, Sang-Don; Park, Hyun Woo; Suh, Jon; Oh, Pyung Chun; Moon, Jeonggeun; Lee, Kyounghoon; Kang, Woong Chol; Kwon, Sung Woo; Kim, Tae-Hoon
- Issue Date
- Jun-2017
- Publisher
- Adis International Ltd.
- Keywords
- Triple antiplatelet therapy might be a better antiplatelet regimen than dual antiplatelet therapy for patients with ST-segment elevation myocardial infarction. Although this benefit was strong in patients aged <75 years; no definite increase in major bleeding was seen for elderly patients (aged ≥75 years).
- Citation
- Drugs and Aging, v.34, no.6, pp 467 - 477
- Pages
- 11
- Journal Title
- Drugs and Aging
- Volume
- 34
- Number
- 6
- Start Page
- 467
- End Page
- 477
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/7548
- DOI
- 10.1007/s40266-017-0463-9
- ISSN
- 1170-229X
1179-1969
- Abstract
- Objectives Compared with dual antiplatelet therapy including aspirin and clopidogrel, triple antiplatelet therapy including cilostazol has a mortality benefit in patients with ST-segment elevation myocardial infarction. However, whether the mortality benefit persists in elderly patients is not clear. Methods From 2007 to 2014, 1278 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were retrospectively analyzed. The patients were divided into four groups by age (<75 or >= 75 years; young and elderly, respectively) and antiplatelet strategy ( triple or dual antiplatelet therapy). We compared the mortality rates between the triple and dual antiplatelet therapy groups. Results There were 1052 (male, 85%; mean age, 56.3 +/- 10.4 years) patients in the young group and 241 (male, 52.7%; mean age, 80.3 +/- 4.5 years) patients in the elderly group. In the young and elderly groups, 220 (20.9%) and 28 (12.3%) patients were treated with triple antiplatelet therapy. During a 1-year follow-up period, 80 patients died (4.2% in the young group vs. 15.5% in the elderly group). Kaplan-Meier survival analysis revealed that triple antiplatelet therapy was associated with a lower mortality rate in the young group (log-rank, p = 0.005). Although there were more angiographic high-risk patients in the elderly group, similar mortality rates were reported (log-rank, p = 0.803) without increased bleeding rates (1 vs. 3.6% in the elderly group, p = 0.217). Conclusions Triple antiplatelet therapy might be a better antiplatelet regimen than dual antiplatelet therapy for patients with ST-segment elevation myocardial infarction. Although this benefit was strong in patients aged <75 years, no definite increase in major bleeding was seen for elderly patients (aged >= 75 years).
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
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