This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in JAMA  Topic Collections  • Prognosis/ Outcomes  • Cardiovascular Disease/ Myocardial Infarction  • Drug Therapy, Other  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Eisenstein and colleagues¹ assessed the association between long-term clopidogrel use and clinical outcomes after drug-eluting stent (DES) implantation. The authors suggested that all patients with DES should continue to take clopidogrel for at least 12 months after intervention and possibly indefinitely. However, some methodological issues need to be considered.

Additional information about the primary outcome measures (death and myocardial infarction) is needed. Defining myocardial infarction according to the diagnosis of the patient's physician may be inaccurate. If available, further information on whether these infarcts were relatively large (Q-wave or associated with significant increases in creatine phosphokinase levels) or only caused minor myocardial damage (limited to troponin level elevation) will help understand if they can be considered as surrogate markers for late DES thrombosis.² Conversely, while mortality was centrally adjudicated, separating deaths into cardiac and noncardiac causes would also be of interest.

Also, the explanation for the . . . [Full Text of this Article]

Fernando Alfonso, MD, PhD
falf@hotmail.com
Cardiovascular Institute
San Carlos University Hospital
Madrid, Spain

RELATED LETTERS

Clopidogrel and Long-term Outcomes After Drug-Eluting Stent Implantation
Aman Khurana and Namita Vinayek
JAMA. 2007;297(16):1769.
EXTRACT | FULL TEXT  

Clopidogrel and Long-term Outcomes After Drug-Eluting Stent Implantation
Alexis Matteau and Jacques LeLorier
JAMA. 2007;297(16):1770.
EXTRACT | FULL TEXT  

Clopidogrel and Long-term Outcomes After Drug-Eluting Stent Implantation
E. Liana Falcone and Navdeep Tangri
JAMA. 2007;297(16):1770.
EXTRACT | FULL TEXT  

Clopidogrel and Long-term Outcomes After Drug-Eluting Stent Implantation—Reply
Eric L. Eisenstein, David F. Kong, Kevin J. Anstrom, and Robert M. Califf
JAMA. 2007;297(16):1770-1771.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Clopidogrel Use and Long-term Clinical Outcomes After Drug-Eluting Stent Implantation
Eric L. Eisenstein, Kevin J. Anstrom, David F. Kong, Linda K. Shaw, Robert H. Tuttle, Daniel B. Mark, Judith M. Kramer, Robert A. Harrington, David B. Matchar, David E. Kandzari, Eric D. Peterson, Kevin A. Schulman, and Robert M. Califf
JAMA. 2007;297(2):159-168.
ABSTRACT | FULL TEXT