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To the Editor: In their observational study, Dr Eisenstein and colleagues¹ suggest that extended use of clopidogrel in patients with DES may be associated with a reduced risk of myocardial infarction and mortality. Although the authors do not explicitly advocate that clopidogrel be used indefinitely in patients with DES, they comment that their findings support the Clopidogrel for the Reduction of Events During Observation (CREDO) trial,² which in turn advocates that all patients with DES should continue to take clopidogrel for at least 12 months and possibly indefinitely.

We believe that the ideal duration of clopidogrel therapy is currently unclear and that, as a result, clinicians may be using this drug indefinitely in patients with DES without regard for cost or complications.

In large clinical trials involving thousands of patients, DES has failed to alter any outcome other than target vessel restenosis.³ Cost analyses of DES that recommend the widespread . . . [Full Text of this Article]

E. Liana Falcone, BSc; Navdeep Tangri, MD
ntangri@yahoo.com
Department of Medicine
McGill University
Montréal, Québec