Autor: |
Rebecca Vigen, Thomas M. Maddox, Colin I. O'Donnell, Gary K. Grunwald, Deepak L. Bhatt, Thomas T. Tsai, John S. Rumsfeld, P. Michael Ho |
Jazyk: |
angličtina |
Rok vydání: |
2016 |
Předmět: |
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Zdroj: |
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 5, Iss 5 (2016) |
Druh dokumentu: |
article |
ISSN: |
2047-9980 |
DOI: |
10.1161/JAHA.114.001376 |
Popis: |
BackgroundPremature clopidogrel discontinuation after drug‐eluting stent placement is associated with adverse outcomes. Little is known about patient and hospital factors associated with premature discontinuation or whether less variation in premature discontinuation exists in integrated health care systems such as the Veterans Affairs (VA). Methods and ResultsWe evaluated the frequency of premature clopidogrel discontinuation, defined as a gap between clopidogrel refills of ≥90 days during the first 6 months of treatment, among 12 707 patients who received drug‐eluting stents in VA hospitals between 2008 and 2010. We evaluated the association between premature discontinuation and all‐cause mortality and/or acute myocardial infarction, variation in the proportion of premature discontinuation among hospitals, the patient and hospital characteristics associated with premature discontinuation, and the extent to which unexplained hospital characteristics contribute to premature discontinuation. Of the patients, 963 (7.6%) discontinued clopidogrel prematurely. Premature discontinuation was associated with acute myocardial infarction and all‐cause mortality (hazard ratio 1.65, 95% CI 1.37–1.99, P |
Databáze: |
Directory of Open Access Journals |
Externí odkaz: |
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