• Dong Yeon Kim, Sung Woo Cho, Kyu Tae Park, Jong Hwa Ahn, Taek Kyu Park, Yong Ho Jang, Ki Hong Choi, Joo Myung Lee, Jeong Hoon Yang, Young Bin Song, Jin Ho Choi, Seung Hyuk Choi, Hyeon Cheol Gwon, Sang Hoon Lee, and Joo Yong Hahn.
• Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea.
• J. Korean Med. Sci. 2021 Apr 26; 36 (16): e106.

BackgroundThere are no data on comparison between clopidogrel monotherapy and prolonged dual antiplatelet therapy (DAPT) in patients at high-risk undergoing percutaneous coronary intervention (PCI).MethodsOf 2,082 consecutive patients undergoing PCI using second-generation drug-eluting stent (DES), we studied 637 patients at high-risk either angiographically or clinically who received clopidogrel longer than 24 months and were event-free at 12 months after index PCI. Patients were divided into 2 groups: the clopidogrel monotherapy group and the prolonged DAPT group. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction (MI), definite or probable stent thrombosis, or stroke between 12 months and 36 months after the index PCI.ResultsIn propensity score-matched population (246 pairs), the cumulative rate of primary outcome was 4.5% in the clopidogrel monotherapy group and 4.9% in the prolonged DAPT group (hazard ratio, 1.21; 95% confidence interval, 0.54-2.75; P = 0.643). There was no significant difference in all-cause death, MI, stent thrombosis, stroke between the clopidogrel monotherapy group and the prolonged DAPT group.ConclusionCompared with prolonged DAPT, clopidogrel monotherapy showed similar long-term outcomes in patients at high-risk after second-generation DES implantation.© 2021 The Korean Academy of Medical Sciences.

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