Efficacy and Safety of Guideline-Recommended Risk Score-Directed Dual Antiplatelet Therapy After 2nd-Generation Drug-Eluting Stentsopen access
- Authors
- Jang, JY[Jang, Ji-Yong]; Lee, BK[Lee, Byoung-Kwon]; Kim, JS[Kim, Jung-Sun]; Shin, DH[Shin, Dong-Ho]; Hong, SJ[Hong, Sung-Jin]; Ahn, CM[Ahn, Chul-Min]; Kim, BK[Kim, Byeong-Keuk]; Ko, YG[Ko, Young-Guk]; Choi, D[Choi, Donghoon]; Hong, MK[Hong, Myeong-Ki]; Park, KW[Park, Kyung Woo]; Gwon, HC[Gwon, Hyeon-Cheol]; Kim, HS[Kim, Hyo-Soo]; Kwon, HM[Kwon, Hyuck Moon]; Jang, Y[Jang, Yangsoo]
- Issue Date
- Feb-2020
- Publisher
- JAPANESE CIRCULATION SOC
- Keywords
- Drug-eluting stent; Dual antiplatelet duration; PRECISE-DAPT risk score
- Citation
- CIRCULATION JOURNAL, v.84, no.2, pp.161 - +
- Indexed
- SCIE
SCOPUS
- Journal Title
- CIRCULATION JOURNAL
- Volume
- 84
- Number
- 2
- Start Page
- 161
- End Page
- +
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/5690
- DOI
- 10.1253/circj.CJ-19-0667
- ISSN
- 1346-9843
- Abstract
- Background: Evaluate the safety and efficacy of guideline-recommended risk score-directed dual antiplatelet therapy (GD-DAPT) based on THE PRECISE-DAPT score after 2nd-generation drug-eluting stent (DES) implantation. Methods and Results: We analyzed 5,131 patients pooled from 4 clinical trials. Patients were divided into 3 groups according to current recommendations on the duration of DAPT and their actual DAPT duration: GD-DAPT (n=2,183), shorter DAPT (n=1,540), longer DAPT (n=1,408). The primary endpoint was the rate of net adverse clinical events (NACE) during the first 12 months. The secondary endpoints were ischemic or bleeding events. Overall, GD-DAPT did not affect NACE (1.2% vs. 1.2% for shorter DAPT and 1.7% for longer DAPT) or bleeding events (0.6% vs. 0.5% and 0.9%), and there were fewer ischemic events (2.8% vs. 4.4% and 4.0%, P=0.03) than with shorter DAPT. Especially in acute coronary syndrome (ACS) patients, GD-DAPT had fewer NACE (1.5% vs. 1.4% and 4.2%; P=0.006) and bleeding events (0.8% vs. 0.5% and 2.8%; P=0.001) than longer DAPT as well as fewer ischemic events (2.8% vs. 4.4% and 4.7%; P=0.03) than shorter DAPT. Conclusions: GD-DAPT did not affect NACE or bleeding events and reduced the number of ischemic events at 12 months compared with shorter DAPT. For ACS, GD-DAPT was associated with favorable outcomes compared with non-GD-DAPT. Therefore, GD-DAPT may optimize efficacy and safety.
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