Prevalence and Predictors of Early Discontinuation of Dual-Antiplatelet Therapy After Drug-Eluting Stent Implantation in Korean Population

Autor: Seung Pyo Lee, Mi Hee Cho, Jae Moon Yun, Hyejin Lee, Eun Ha Kim, Hyun Kyoung Kim, Joong Hyun Shin, Yoo Kyoung Lim, Dong Wook Shin
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
Ticlopidine
Time Factors
030204 cardiovascular system & hematology
Medication prescription
Coronary Restenosis
03 medical and health sciences
Young Adult
0302 clinical medicine
Percutaneous Coronary Intervention
Risk Factors
Internal medicine
Republic of Korea
Prevalence
Medicine
Humans
030212 general & internal medicine
Prospective cohort study
Aged
Retrospective Studies
Aspirin
Dose-Response Relationship
Drug
business.industry
Coronary Stenosis
Retrospective cohort study
Drug-Eluting Stents
Middle Aged
Clopidogrel
Surgery
Discontinuation
Withholding Treatment
Cohort
Cardiology
Platelet aggregation inhibitor
Patient Compliance
Drug Therapy
Combination
Female
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
medicine.drug
Follow-Up Studies
Zdroj: The American journal of cardiology. 118(10)
ISSN: 1879-1913
Popis: The administration of antiplatelet drugs for months after a drug-eluting stent implantation is critical in decreasing the risk of complications, and premature discontinuation of antiplatelet therapy before the recommended period is the most important predictor for late complications. Therefore, we investigated the prevalence and associated factors of premature discontinuation of antiplatelet therapy in patients in Korea. This retrospective cohort study was conducted using the Korean National Health Insurance Service-National Sample Cohort data. Patients who were treated with dual-antiplatelet therapy (DAPT) were identified with medication prescription data. The Kaplan-Meier failure time plot was used to illustrate the cumulative probability of treatment discontinuation. Cox regression analysis was conducted to compare predictors of early discontinuation of DAPT. The characteristics of the early discontinuation group were not significantly different from the guideline concordance group, except for a higher prevalence of disability and a lower rate of chronic kidney disease. In a Cox regression model, the presence of hypertension was identified as a negative predictor of early discontinuation, and disability was not a statistically significant predictor. The prevalence of early discontinuation was 31.0% and seems to be significantly higher than those reported from prospective studies, which may more accurately reflect the real-world situation. In conclusion, physicians should make more effort to educate patients on the risk associated with premature discontinuation of antiplatelet therapy after percutaneous coronary intervention with drug-eluting stent, and further studies investigating the reasons for nonadherence of DAPT are needed to improve DAPT compliance.
Databáze: OpenAIRE
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