Objective: To determine the association between the discontinuation of clopidogrel therapy prior to 1 year and the risk of acute myocardial infarction (AMI) hospitalization, coronary intervention or all-cause mortality in a cohort of managed-care patients following AMI hospitalization or stent insertion.
Research Design And Methods: This observational cohort study included 1152 patients enrolled in the Health Alliance Plan who were hospitalized for AMI, or who underwent coronary stent placement. Clopidogrel use was assessed using pharmacy claims data. The association between discontinuation of clopidogrel prior to 1 year following the initial ACS event and the primary outcome of AMI hospitalization/procedure was assessed using Cox proportional hazards models. Additionally, an analysis was conducted to determine the association of discontinuation prior to 1 year with a secondary composite outcome of AMI hospitalization/coronary stent procedure or all-cause mortality.
Main Outcome Measures: The primary outcome was AMI hospitalization or procedure. The secondary outcome was a composite of AMI hospitalization/ procedure, or all-cause mortality.
Results: Discontinuation of clopidogrel in the total cohort of patients was associated with a significantly higher risk of the primary outcome of AMI hospitalization/ coronary intervention (HR 2.712, 95% CI 1.634-4.502). Consistent with this finding, discontinuation of clopidogrel was also associated with a significantly higher risk of the secondary composite endpoint (HR 1.844, 95% CI 1.281-2.653).
Conclusions: In patients enrolled in an integrated health network, clopidogrel discontinuation prior to 1 year following AMI hospitalization or stent placement is associated with adverse outcomes including greater risk of death, AMI hospitalization or coronary intervention. These results should be interpreted within the context and limitations of observational research, which cannot attribute causality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1185/03007990903156061 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
[Association between serum BIN1 level and Killip class in patients with acute myocardial infraction].
Nan Fang Yi Ke Da Xue Xue Bao
December 2024
Fifth Clinical Medical College of Shanxi Medical University, Taiyuan 030012, China.
Objectives: To investigate the correlation of serum levels of bridging integrating factor 1 (BIN1) with acute myocardial infarction (AMI) and Killip class of the patients.
Methods: We retrospectively collected the data from 94 patients with AMI and 30 healthy individuals for analysis of the correlations of serum BIN1 levels with Killip class, TIMI scores, and neutrophil-to-lymphocyte ratio (NLR). We also assessed the diagnostic value of BIN1 combined with NLR for AMI.
Association between BMI and cause-specific long-term mortality in acute myocardial infarction patients.
Am J Prev Cardiol
March 2025
Epidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany.
Aims: To investigate the association between body mass index (BMI) at acute myocardial infarction (AMI) and all-cause as well as cause-specific long-term mortality.
Methods: The analysis was based on 10,651 hospitalized AMI patients (age 25-84 years) recorded by the population-based Myocardial Infarction Registry Augsburg between 2000 and 2017. The median follow-up time was 6.
Circadian rhythm pattern of symptom onset in patients with ST-segment elevation myocardial infarction in the Chinese population.
Front Cardiovasc Med
December 2024
Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China.
Background: The peak incidence of cardiovascular diseases (CVD) usually occurs in the morning. This study aimed to investigate the exact distribution pattern of peak incidence of ST-segment elevation myocardial infarction (STEMI) in the Chinese population, and to explore whether it is associated with the prognosis.
Methods: This study included 7,805 patients with STEMI from the multicenter, prospective AMI cohort in China, for whom had a definite time of symptom onset.
The prognostic impact of stress hyperglycemia ratio on mortality in cardiogenic shock: a MIMIC-IV database analysis.
Diabetol Metab Syndr
December 2024
Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
Background: The stress hyperglycemia ratio (SHR) has been established as a predictor of unfavorable outcomes across various diseases. However, its relationship with prognosis in patients with cardiogenic shock (CS) remains unclear. This study aims to investigate the association between SHR and outcomes in CS patients.
View Article and Find Full Text PDFAerobic exercise inhibits GSDME-dependent myocardial cell pyroptosis to protect ischemia-reperfusion injury.
Mol Med
December 2024
Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China.
Background: Acute myocardial infarction (AMI) remains a significant cause of global mortality, exacerbated by ischemia-reperfusion (IR) injury. Myocardial cell pyroptosis has emerged as a critical pathway influencing IR injury severity.
Methods: We aimed to investigate the cardioprotective effects of aerobic exercise on IR injury by examining the modulation of IGFBP2 and its impact on GSDME-dependent myocardial cell pyroptosis.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!