Patients who received percutaneous coronary intervention (PCI) should be treated with dual anti-platelet therapy (DAPT). DAPT significantly lowers the risk of the incidence of major adverse cardiac events (MACE). However, the risk factors for the incidence of MACE are unclear. We investigated the relationship between the incidence of MACE in PCI treated patients who underwent combined therapy by clopidogrel and aspirin, and patient background, present clinical history, lifestyle, and concomitant drugs. Between the MACE symptom group and non-MACE group, there were no significant differences in terms of patient background and lifestyle. In the MACE-symptom group, the percentage of treatments using concomitant drugs that inhibits cytochrom P450 (CYP)3A4 activity was significantly higher than in the non-MACE group (odds ratio 2.70). The present study also demonstrated that diabetes was an important risk factor (odds ratio 3.16, P = 0.001) of MACE symptoms. A significant positive correlation was found between diabetes and hypertension morbidity, and the administration ratio of concurrent drugs with CYP3A4 inhibition activity. The present study suggests that diabetes morbidity may be associated with MACE symptoms in antiplatelet therapy with DAPT.

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