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Safety of 3-Month Dual Antiplatelet Therapy After Implantation of Ultrathin Sirolimus-Eluting Stents With Biodegradable Polymer (Orsiro): Results From the SMART-CHOICE Trial

Authors
Yun, Kyeong HoLee, Seung-YulCho, Byung RyulJang, Woo JinSong, Young BinOh, Ju-HyeonChun, Woo JungPark, Yong HwanIm, Eul-SoonJeong, Jin-OkOh, Seok KyuCho, Deok-KyuLee, Jong-YoungKoh, Young-YoupBae, Jang-WhanChoi, Jae WoongLee, Wang SooYoon, Hyuck JunLee, Seung UkCho, Jang HyunChoi, Woong GilRha, Seung-WoonLee, Joo MyungPark, Taek KyuYang, Jeong HoonChoi, Jin-HoChoi, Seung-HyuckLee, Sang HoonGwon, Hyeon-CheolHahn, Joo-Yong
Issue Date
Jan-2021
Publisher
WILEY
Keywords
antiplatelet therapy; coronary artery disease; percutaneous coronary intervention
Citation
JOURNAL OF THE AMERICAN HEART ASSOCIATION, v.10, no.1, pp 1 - 9
Pages
9
Journal Title
JOURNAL OF THE AMERICAN HEART ASSOCIATION
Volume
10
Number
1
Start Page
1
End Page
9
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/54113
DOI
10.1161/JAHA.120.018366
ISSN
2047-9980
2047-9980
Abstract
BACKGROUND: This study sought to investigate the safety of 3-month dual antiplatelet therapy (DAPT) in patients receiving ultrathin sirolimus-eluting stents with biodegradable polymer (Orsiro). METHODS AND RESULTS: The SMART-CHOICE (Smart Angioplasty Research Team: Comparison Between P2Y12 Antagonist Monotherapy vs Dual Anti- platelet Therapy in Patients Undergoing Implantation of Coronary Drug-Eluting Stents) randomized trial compared 3-month DAPT followed by P2Y12 inhibitor monotherapy with 12-month DAPT in 2993 patients undergoing percutaneous coronary intervention. The present analysis was a prespecified subgroup analysis for patients receiving Orsiro stents. As a post hoc analysis, comparisons between Orsiro and everolimus-eluting stents were also done among patients receiving 3-month DAPT. Of 972 patients receiving Orsiro stents, 481 patients were randomly assigned to 3-month DAPT and 491 to 12-month DAPT. At 12 months, the target vessel failure, defined as a composite of cardiac death, target vessel-related myocardial infarction, or target vessel revascularization, occurred in 8 patients (1.7%) in the 3-month DAPT group and in 14 patients (2.9%) in the 12-month DAPT group (hazard ratio [HR], 0.58; 95% CI, 0.24-1.39; P=0.22). In whole population who were randomly assigned to receive 3-month DAPT (n=1495), there was no significant difference in the target vessel failure between the Orsiro group and the everolimus-eluting stent group (n=1014) (1.7% versus 1.8%; HR, 0.96; 95% CI, 0.41-2.22; P=0.92). CONCLUSIONS: In patients receiving Orsiro stents, clinical outcomes at 1 year were similar between the 3-month DAPT followed by P2Y12 inhibitor monotherapy and 12-month DAPT strategies. With 3-month DAPT, there was no significant difference in target vessel failure between Orsiro and everolimus-eluting stents.
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