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Short-term versus Long-term Clopidogrel Maintenance after Endeavor Zotarolimus-Eluting Stent Deployment
연세대학교 강남세브란스병원 심장내과 ¹ ,연세대학교 신촌세브란스병원 심장내과² ,국민건강보험공단 일산병원 심장내과³ ,인제대학교 상계백병원 심장내과⁴ ,경희대학교병원 심장내과5 ,단국대학교병원 심장내과6 , 이화대학교 목동병원 심장내과7 ,연세대학교 원주의과대학 원주기독병원 심장내과8 ,한림대학교 강남성심병원 심장내과9
홍범기¹, 문희선¹ ,민필기¹ ,이병권¹ ,권혁문¹ ,장양수² ,최동훈² ,김중선² ,양주영³ ,전동운³ ,오성진³ ,김병극³ ,김병옥⁴ ,고충원⁴ ,김명곤5 ,박병은6 ,강태수6 ,권기환7 ,윤정한8 ,이승환8 ,조정래9
Background; Recently major concerns emerged about the stent thrombosis after drug-eluting stent implantation that has been strongly associated with discontinuation of antiplatelet therapy. However the optimum duration of antiplatelet therapy is still investigated. The Endeavor stent elutes zotarolimus via a biocompatible polymer. This trial compared the safety and efficacy of short versus long-term Clopidogrel therapy after Endeavor deployment. Methods and Results; In 9 centers in Korea, 163 patients were enrolled for short term Clopidogrel therapy group that prescribes for 3 months, and 657 patients were reviewed for long term group that maintained for more than 6 months after Endeavor stenting from August 2006 to October 2007. After propensity score matching, 75 patients were remained in short term group and 225 patients in long term group. Baseline demographics and angiographic characteristics were not significantly different between two groups. There was no episode of stent thrombosis in two groups. There were no significant differences between short and long-term Clopidogrel therapy group in death (1.3% vs 0%, respectively; p=0.19), myocardial infarction (1.3% vs 1.3%, p=0.85), target lesion revascularization (6.3% vs 6.6%, p=0.07), and total MACE (7.8% vs 7.6%, p=0.05). In stent late lumen loss at 9 months were 0.45±0.74 vs 0.54±0.67mm (p=0.39). Conclusion; In addition to efficacy, this study strongly supports the safety of 3-month Clopidogrel maintenance after deployment of Endeavor stent. Longer follow-up in a larger patient cohort should be warranted.

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