Abstract 4452: What are the Reasons for Clopidogrel Discontinuation after PCI?
Background: Current recommendations are for 12 months of clopidogrel therapy after PCI, in particular after drug-eluting stents (DES). There is limited data on the reasons for clopidogrel discontinuation before or after the one-year mark. The reasons for, and time course of, clopidogrel discontinuation were assessed in this study.
Methods: In our percutaneous coronary interventions (PCI) outcomes database we prospectively identified 557 patients that had discontinued clopidogrel during the follow-up period after PCI, of which 424 (76%) provided their motivation for clopidogrel discontinuation. Duration of clopidogrel use was calculated starting from the index PCI. Patients who discontinued it after a bleeding event requiring hospitalization were considered to have a major bleeding event, while bleeding not requiring hospitalization was considered minor. Adverse drug reactions leading to hematologic changes, angioedema, or liver dysfunction were considered major, while a rash was considered a minor adverse reaction.
Results: The average age among the cohort was 67± 11 years and 31% were female. There was no difference for either age or gender by time of clopidogrel discontinuation (p>0.3). The mean duration of clopidogrel administration was 336 ± 197 days. The reasons for clopidogrel discontinuation are tabulated below.
Conclusion: The reasons for clopidogrel discontinuation after PCI are variable. Major and minor bleeding was more common in the first year post PCI. Patients continuing therapy beyond one year appear to be at low risk for major and minor bleeding.