title: Comparison of triple anti-platelet therapy and dual anti-platelet therapy in patients with acute myocardial infarction who had no-reflow phenomenon during percutaneous coronary intervention.
abstract: BACKGROUND
  No-reflow phenomenon is a serious complication of percutaneous coronary intervention (PCI) and associated with poor prognosis. The aim of this study was to determine whether triple anti-platelet therapy could improve clinical outcome in patients with acute myocardial infarction (AMI) who had no-reflow phenomenon during PCI compared with dual anti-platelet therapy.
  
  
  RESULTS
  A total of 727 eligible patients received either dual anti-platelet therapy (aspirin and clopidogrel; dual group, n=532) or triple anti-platelet therapy (aspirin, clopidogrel, and cilostazol; triple group, n=195). The triple group received additional cilostazol for at least 1 month. One-year major adverse cardiac events (MACE) including death, myocardial infarction (MI), target vessel revascularization (TVR) and coronary artery bypass graft (CABG) were evaluated. The triple group had a similar incidence of major bleeding and in-hospital mortality compared with the dual group. At 1 year, the triple group had significantly lower cardiac mortality (17.7% vs. 11.8%, log-rank P=0.039), lower all-cause mortality (19.0% vs. 12.3%, log-rank P=0.035), and lower incidence of composite MACE (25.9% vs. 16.9%, adjusted hazard ratio, 0.50; 95% confidence interval: 0.31-0.80, P=0.004) compared with the dual group with no differences in MI and TVR.
  
  
  CONCLUSIONS
  Triple anti-platelet therapy seems to be superior to dual anti-platelet therapy in patients with AMI who had no-reflow phenomenon during PCI.
authors.affiliation: Chonnam National University Hospital.
authors.forename: Ki Hong
authors.initials: KH
authors.lastname: Lee
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Shi Hyun
authors.initials: SH
authors.lastname: Rhew
authors.forename: Young Wook
authors.initials: YW
authors.lastname: Jeong
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Jang
authors.forename: Jae Yeong
authors.initials: JY
authors.lastname: Cho
authors.forename: Hae Chang
authors.initials: HC
authors.lastname: Jeong
authors.forename: Keun-Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000401:mortality* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D015996:Survival Rate
chemical_list: D010975:Platelet Aggregation Inhibitors