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GENERAL CARDIOLOGY
After stopping aspirin or heparin treatment for an acute coronary syndrome (ACS), a clustering of thrombotic events has been described–the so-called "rebound phenomenon". Could the same phenomenon occur with clopidogrel, and might this explain recent reports of late stent thrombosis following its discontinuation?
Three thousand, one hundred and thirty-one patients were retrospectively selected from the Department of Veterans Affairs (VA) Veterans Health Administration Cardiac Care Follow-up Clinical Study, which uses national data for quality monitoring in the United States. All had had an ACS and had been discharged on clopidogrel treatment. The authors examined the rates of all-cause mortality or acute myocardial infarction after stopping clopidogrel treatment.
Among medically treated patients, the mean duration of clopidogrel treatment was 302 days, and death or myocardial infarction occurred in 17.1% (n = 268). 60.8% (n = 163) of events occurred 0–90 days after cessation of clopidogrel treatment, 21.3% (n = 57) occurred
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