In:
Circulation: Cardiovascular Interventions, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 7 ( 2018-07)
Abstract:
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
Type of Medium:
Online Resource
ISSN:
1941-7640
,
1941-7632
DOI:
10.1161/CIRCINTERVENTIONS.117.005849
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2018
detail.hit.zdb_id:
2450801-9
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