Impact of dual antiplatelet therapy duration on clinical outcome after coronary bifurcation stenting: results from the euro bifurcation club registry
Panminerva med
; 65(1)May. 2022.
Artigo
em Inglês
| CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1378104
Biblioteca responsável:
BR79.1
ABSTRACT
BACKGROUND:
Optimal duration of Dual Antiplatelet Therapy (DAPT) following percutaneous coronary intervention (PCI) of a bifurcation stenosis is still debated. We evaluated the impact of DAPT duration on clinical outcomes in all-comers patients undergoing bifurcation PCI included in the European Bifurcation Club (EBC) registry.METHODS:
We enrolled 2284 consecutive patients who completed at least 18 months follow-up. The cumulative occurrence of Major Adverse Cardiac and Cardiovascular Events (MACCE), defined as a composite of overall-death, non-fatal myocardial infarction (MI), target vessel revascularization (TVR) and stroke were evaluated. Bleedings classified as BARC ≥ 3 were evaluated too.RESULTS:
Patients were divided into 3 groups Short DAPT (<6-months, n=375); Standard DAPT (≥6-months but ≤12-months, n=636); Prolonged DAPT (>12- months, n=1273). At 24 months follow-up MACCE-free survival was significantly lower in Short DAPT patients (Log-Rank 45.23, p for trend <0.001). MACCE occurred less frequently in the Prolonged DAPT group (148 (11.6%)) as compared with both the Short (83 (22.1%) HR0.48 (0.37-0.63), p<0.001) and Standard DAPT groups (137 (21.5%) HR0.51 (0.41-0.65), p<0.001). These differences remain after propensity score adjustment (respectively, HR 0.27 (0.20-0.36) and HR 0.44 (0.34-0.57)). Such finding was consistent in patients presenting with both acute and chronic coronary syndromes. BARC ≥ 3 bleedings were 0.3% in the Standard DAPT, 1.6% in Short and 1.9% in Prolonged DAPT groups.CONCLUSIONS:
In the "real-world" EBC registry of patients undergoing PCI of coronary artery bifurcation stenosis, a prolonged DAPT duration was associated with a significantly lower risk of MACCE and a potential increased risk of major bleedings.
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Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
CONASS
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Sec. Est. Saúde SP
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SESSP-IDPCPROD
Assunto principal:
Inibidores da Agregação Plaquetária
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Intervenção Coronária Percutânea
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Duração da Terapia
Idioma:
Inglês
Revista:
Panminerva med
Ano de publicação:
2022
Tipo de documento:
Artigo
Instituição/País de afiliação:
CIBERCV, Hospital Clínico Universitario de Valladolid/ES
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Cardiology Department, Fattouma Bourguiba Hospital, University of Monastir/TN
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City Clinic/BG
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Department of Cardiology and Angiology, University Medical Centre/SI
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Department of Cardiology, Clinical Center of Serbia, University of Belgrade/RS
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Department of Cardiology, New Tokyo Hospital/JP
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Department of Cardiovascular Medicine, University Hospital Centre/HR
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Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior/PL
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Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples/IT
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Institute of Cardiology G. d'Annunzio University/IT