International Journal of the Cardiovascular Academy (Jan 2018)

Predictors of premature clopidogrel discontinuation within 30 days of successful coronary artery stenting

  • Çayan Cakir,
  • Haci Ates,
  • Baris Kiliçaslan,
  • Cem Nazli,
  • Oktay Ergene

DOI
https://doi.org/10.4103/IJCA.IJCA_2_18
Journal volume & issue
Vol. 4, no. 1
pp. 1 – 5

Abstract

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Objective: We aimed to determine the prevalence, predictors, and mortality rate of premature clopidogrel discontinuation within 30 days of successful coronary stenting. Methods: All consecutive patients who underwent successful coronary stent implantation at our hospital between December 2006 and December 2007 were prospectively included in this study. Patients were interviewed by telephone 30 days after stent implantation. Premature clopidogrel discontinuation was defined as follows: patients who did not continue clopidogrel after discharge were defined as “never used” and patients who received clopidogrel for <20 days or interrupted therapy for at least 5 successive days within the first 30 days were defined as “partially used.” Results: Follow-up data were available for 381 patients and 58 (15.2%) patients reported premature clopidogrel discontinuation. No mortality and only 1 (0.3%) stent thrombosis occurred in adherent patients, whereas there were 2 (3.4%) mortalities and 6 (10.3%) stent thrombosis in the patients who prematurely discontinued clopidogrel. Those who discontinued clopidogrel therapy were older (P = 0.02), more likely to be female (P = 0.02), single (P = 0.03), of lower economic (P < 0.05) and educational status (P < 0.01), more likely to have chronic disease (P = 0.04), less likely to have undergone previous stenting (P = 0.01), and were more likely to be receiving a larger number of drugs (P < 0.05). In multivariate analysis, low- or intermediate-economic status, no history of previous stent implantation, and total number of prescribed drugs using were factors independently associated with premature clopidogrel discontinuation. Conclusion: This study demonstrates several predictors of premature clopidogrel discontinuation. This data may help clinicians pay particular attention to these patients in an attempt to improve the outcomes of coronary stenting.

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