Efficacy and safety of triple antiplatelet therapy in obese patients undergoing stent implantation.
We evaluated the impact of triple antiplatelet therapy on platelet reactivity, reducing cardiovascular events and the safety in obese patients undergoing coronary stenting. Obese patients (n = 428) undergoing coronary stenting were randomly assigned to 2 groups: standard dual group (clopidogrel plus aspirin, n = 215) and triple group (n = 213); adjunctive cilostazol was added to the dual group treatment. Platelet reactivity was assessed at baseline and at 1-year follow-up by conventional aggregometry. Major adverse cardiovascular events, stent thrombosis, target lesion revascularization (TLR), target vessel revascularization, and bleeding events were analyzed after 1-year follow-up. At 1-year follow-up after stenting, major adverse cardiac events including death, myocardial infarction, and ischemic-driven TLR were lower in the triple group than the dual group. Major bleeding was similar in both the groups. In obese patients undergoing percutaneous coronary intervention, triple antiplatelet therapy was superior to dual antiplatelet therapy in decreasing thrombotic events in 12-month cardiac events, mainly driven by a decrease in the incidence of clopidogrel resistance.
Department of Cardiology, Bayannaoer City Hospital, Inner Mongolia, China.
Wen
W
Gao
Qinghua
Q
Zhang
Hailong
H
Ge
Yonghe
Y
Guo
Zhiming
Z
Zhou
D000328:Adult; D000368:Aged; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001792:Blood Platelets / Q000187:drug effects*; D000077407:Cilostazol; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019919:Prosthesis Implantation; D015607:Stents; D013777:Tetrazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin
clopidogrel; obesity; resistance antiplatelet