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Benefit of Prolonged Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stent for Coronary Bifurcation Lesions: Results From the Coronary Bifurcation Stenting Registry II

Authors
Jang, WJ | Ahn, SG | Song, YB | Choi, SH | Chun, WJ | Oh, JH | Cho, SW | Kim, BS | Yoon, JH | Koo, BK | Yu, CW | Jang, YS | Tahk, SJ  | Kim, HS | Gwon, HC | Lee, SY | Hahn, JY
Citation
Circulation. Cardiovascular interventions, 11(7). : e005849-e005849, 2018
Journal Title
Circulation. Cardiovascular interventions
ISSN
1941-76401941-7632
Abstract
BACKGROUND: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain.
METHODS AND RESULTS: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT >/=12-month group (n=1776) and DAPT <12-month group (n=306). Primary outcome was all-cause death or MI. At 4 years after the index procedure, death or MI occurred less frequently in the DAPT >/=12-month group than the DAPT <12-month group (2.8% versus 12.3%: adjusted hazard ratio, 0.21: 95% confidence interval, 0.13-0.35: P<0.001). After propensity score matching, incidence of death or MI was still lower in the DAPT >/=12-month group than the DAPT <12-month group (2.6% versus 12.3%: adjusted hazard ratio, 0.22: 95% confidence interval, 0.12-0.38: P<0.001). In subgroup analysis, the treatment effect of prolonged DAPT was consistent across subgroups regardless of lesion location, stenting technique, or type of used drug-eluting stent.
CONCLUSIONS: The risk of all-cause death or MI was significantly lower in the >/=12-month DAPT group than the <12-month DAPT group after percutaneous coronary intervention for bifurcation lesion using drug-eluting stent. Our results suggest that prolonged DAPT may improve long-term clinical outcomes after percutaneous coronary intervention for bifurcation lesions.
CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01642992.
Keywords

MeSH

DOI
10.1161/CIRCINTERVENTIONS.117.005849
PMID
30006330
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
Ajou Authors
탁, 승제
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