Abstract 18483: Randomized, Double Blind Trial of Tapered versus Abrupt Interruption of Long Term Clopidogrel Therapy After Drug-Eluting Stent Implantation - ISAR-CAUTION
Purpose: Observational data suggest clustering of thrombotic events after cessation of antithrombotic therapy in patients with coronary artery disease. The underlying mechanism has been ascribed to a potential rebound platelet activity after discontinuation of chronic clopidogrel therapy. This may have a negative impact particularly in patients receiving drug-eluting stents. We therefore hypothesized that gradual clopidogrel therapy cessation attenuates the potential risks associated with abrupt clopidogrel therapy cessation in that patient population.
Methods: Patients with planned discontinuation of chronic clopidogrel therapy after drug-eluting stent implantation were randomized in a double-blinded fashion to either gradual or abrupt interruption of clopidogrel therapy. The primary endpoint is a composite of cardiac death, myocardial infarction, stroke, stent thrombosis (definite or probable), major bleeding or rehospitalisation due to an acute coronary syndrome at 3 months after randomization. The trial is registered with ClinicalTrials.gov Identifier: NCT00640679.
Results: Enrollment was stopped prematurely due to slow recruitment. A total of 782 patients were enrolled. Follow-up has been completed. Results will be available in June 2013.
Conclusions: The results will help to define the best way of clopidogrel therapy cessation after drug-eluting stent implantation.
- © 2013 by American Heart Association, Inc.