Efficacy and safety of antiplatelet-combination therapy after drug-eluting stent implantation
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Background/Aims: Combination single-pill therapy can improve cost-effectivenessin a typical medical therapy. However, there is a little evidence about theefficacy and tolerability of combination single-pill antiplatelet therapy after percutaneouscoronary intervention (PCI) with drug-eluting stents (DES). Methods: From June to November 2012, in total, 142 patients who met the followingcriteria were enrolled: at least 18 years old; successful PCI with DES at least 3months earlier; and regular medication of aspirin and clopidogrel with no sideeffects. After VerifyNow P2Y12 and aspirin assays, the combination single pill ofaspirin and clopidogrel was given and laboratory tests were repeated 6 weeks later. Results: At baseline, the incidence of aspirin resistance, defined as aspirin reactionunit (ARU) ≥ 550, was 9.2%, that of clopidogrel resistance, defined as P2Y12reaction unit (PRU) ≥ 230, was 46.5%, and that of percent inhibition of PRU <20% was 32.4%. At follow-up, the incidence of resistance by ARU value was 7.0%,50.0% by PRU value, and 35.9% by percentage inhibition of PRU, respectively. Themean values of ARU (431.5 ± 63.6 vs. 439.8 ± 55.2; p = 0.216) and PRU (227.5 ± 71.4vs. 223.3 ± 76.0; p = 0.350) were not significantly different before versus after antiplatelet-combination single-pill therapy. Five adverse events (3.5%) were observedduring the study period. Conclusions: Combination single-pill antiplatelet therapy, which may reduce dailypill burden for patients after PCI with DES, demonstrated similar efficacy toseparate dual-pill antiplatelet therapy.
Abstract
Background/Aims: Combination single-pill therapy can improve cost-effectivenessin a typical medical therapy. However, there is a little evidence about theefficacy and tolerability of combination single-pill antiplatelet therapy after percutaneouscoronary intervention (PCI) with drug-eluting stents (DES). Methods: From June to November 2012, in total, 142 patients who met the followingcriteria were enrolled: at least 18 years old; successful PCI with DES at least 3months earlier; and regular medication of aspirin and clopidogrel with no sideeffects. After VerifyNow P2Y12 and aspirin assays, the combination single pill ofaspirin and clopidogrel was given and laboratory tests were repeated 6 weeks later. Results: At baseline, the incidence of aspirin resistance, defined as aspirin reactionunit (ARU) ≥ 550, was 9.2%, that of clopidogrel resistance, defined as P2Y12reaction unit (PRU) ≥ 230, was 46.5%, and that of percent inhibition of PRU <20% was 32.4%. At follow-up, the incidence of resistance by ARU value was 7.0%,50.0% by PRU value, and 35.9% by percentage inhibition of PRU, respectively. Themean values of ARU (431.5 ± 63.6 vs. 439.8 ± 55.2; p = 0.216) and PRU (227.5 ± 71.4vs. 223.3 ± 76.0; p = 0.350) were not significantly different before versus after antiplatelet-combination single-pill therapy. Five adverse events (3.5%) were observedduring the study period. Conclusions: Combination single-pill antiplatelet therapy, which may reduce dailypill burden for patients after PCI with DES, demonstrated similar efficacy toseparate dual-pill antiplatelet therapy.
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