Background: The difference of the clinical outcomes between nonextended (≤12 months) and extended (>12 months) dual antiplatelet therapy (DAPT) remains unclear in patients with acute myocardial infarction (AMI) implanted by different generations of drug-eluting stent (DES). Methods: We identified 790 consecutive patients with AMI who were free from major adverse cardiac events for 12 months after first-generation (n = 537) or second-generation DES (n = 253) implantation; each DES generation group was further divided into nonextended and extended DAPT. Results: During follow-up (median: 40 months), nonextended DAPT in the first-generation DES group showed a higher rate of cardiac death or MI than was observed in the extended DAPT group (14% vs 2%, P < 0.001). However, in the second-generation DES group, there was no difference in the occurrence of cardiac death and MI between the extended and nonextended groups (4% vs 3%, P = 0.809). Nonextended DAPT was the most significant predictor of cardiac death and MI for first-generation DES implantation [hazard ratio (HR) = 5.47, 95% confidence interval (CI) = 1.53-19.59, P = 0.009] but not for second-generation DES implantation [HR = 3.21, 95% CI = 0.21-50.65, P = 0.401]. Conclusion: This study suggested that the clinical outcomes between nonextended and extended DAPT might be different depending on the generation of implanted DESs in patients with AMI.
All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine