Dual antiplatelet therapy beyond 12 months versus for 12 months after drug-eluting stents for acute myocardial infarction
- Authors
- Sim, DS[Sim, Doo Sun]; Jeong, MH[Jeong, Myung Ho]; Kim, HS[Kim, Hyo Soo]; Gwon, HC[Gwon, Hyeon Cheol]; Seung, KB[Seung, Ki Bae]; Rha, SW[Rha, Seung Woon]; Chae, SC[Chae, Shung Chull]; Kim, CJ[Kim, Chong Jin]; Cha, KS[Cha, Kwang Soo]; Park, JS[Park, Jong Seon]; Yoon, JH[Yoon, Jung Han]; Chae, JK[Chae, Jei Keon]; Joo, SJ[Joo, Seung Jae]; Choi, DJ[Choi, Dong Ju]; Hur, SH[Hur, Seung Ho]; Seong, IW[Seong, In Whan]; Cho, MC[Cho, Myeong Chan]; Kim, DI[Kim, Doo Il]; Oh, SK[Oh, Seok Kyu]; Ahn, TH[Ahn, Tae Hoon]; Hwang, JY[Hwang, Jin Yong]
- Issue Date
- Jan-2020
- Publisher
- ELSEVIER
- Keywords
- Antiplatelet agents; Drug-eluting stents; Myocardial infarction
- Citation
- JOURNAL OF CARDIOLOGY, v.75, no.1, pp.66 - 73
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CARDIOLOGY
- Volume
- 75
- Number
- 1
- Start Page
- 66
- End Page
- 73
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/6028
- DOI
- 10.1016/j.jjcc.2019.06.006
- ISSN
- 0914-5087
- Abstract
- Background: The optimal duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome remains uncertain. This study investigated the benefit of DAPT beyond 12 months after drug-eluting stents (DES) for acute myocardial infarction (MI). Methods: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 6199 patients treated with DAPT for 12 months after DES (second-generation DES 98%) without ischemic or bleeding events were analyzed. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of death from any cause, MI, or ischemic stroke during the period from 12 to 24 months. Results: After adjustment using inverse probability of treatment weighting, patients who received DAPT beyond 12 months (n = 4795), compared to patients treated with 12-month DAPT (n = 1404), had a similar incidence of MACCE (1.3% vs. 1.0%, HR: 1.32, 95% CI: 0.71-2.45, p = 0.378). The 2 groups did not differ significantly in the rates of death (0.1% vs. 0.1%), MI (0.8% vs.0.6%), stent thrombosis (0.1% vs. 0.2%), ischemic stroke (0.4% vs. 0.2%), and major bleeding (0.1% vs. 0.1%). The rate of net adverse clinical events was 1.4% with DAPT beyond 12 months and 1.1% with 12-month DAPT (p = 0.466). Conclusions: DAPT beyond 12 months, as compared with 12-month DAPT, in real-world patients with acute MI treated predominantly with second-generation DES did not reduce the risk of MACCE. The rates of major bleeding and net adverse clinical events did not differ significantly between the 2 treatments. (C) 2019 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
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