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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
VELASQUEZ, Jorge Guillermo et al. Incidence of major adverse cardiovascular events associated to suspension of dual antiplatelet therapy in patients with coronary disease and stent implants. Rev. Colomb. Cardiol. [online]. 2017, vol.24, n.4, pp.342-350. Epub Jan 12, 2017. ISSN 0120-5633. https://doi.org/10.1016/j.rccar.2016.10.038.
Objective:
To determine the risk of developing major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome and stent implant who suspended dual antiplatelet therapy before one year of treatment.
Methods:
Analytical study of patients with acute coronary syndrome and stent implant who received dual antiplatelet therapy upon hospital admission. Sociodemographic, clinical and paraclinical features were described. The prevalence of dual antiplatelet therapy suspensión before one year of treatment was determined, and for assessing the risk of major adverse cardiovascular events a Cox proportional hazard regression model was used.
Results:
873 patients were included. Prevalence of dual antiplatelet therapy suspension was 39.18%. The group who continued the therapy during a year had a higher frequency of previous coronary disease (19.13%, p = 0.03). The main indication for the procedure in patients who interrupted their treatment was infarction without ST elevation (36.8%). Dual therapy suspensión before one year was not related to a higher incidence of MACEs after one year (HR1.31, CI 95% 0.65-2.62 p = 0.45). The presence of peripheral arterial disease, diabetes mellitus and more than one abnormal vessel was related to adverse cardiovascular effects within one year.
Conclusions:
The suspension of dual antiplatelet therapy before twelve months in patients with a stent implant posterior to an acute coronary syndrome is frequent and does not seem to be associated to a higher incidence of major adverse cardiovascular events; nevertheless, the reason for the interruption could influence the clinical outcome and must be taken into account for clinical practice.
Keywords : Acute coronary syndrome; Major adverse cardiovascular events; Platelet aggregation inhibitors.