Effects of Prolonged Dual Antiplatelet Therapy in ST-Segment Elevation vs. Non-ST-Segment Elevation Myocardial Infarction
- Authors
- Kim, J[Kim, Jihoon]; Song, YB[Song, Young Bin]; Oh, JH[Oh, Ju-Hyeon]; Cho, DK[Cho, Deok-Kyu]; Lee, JB[Lee, Jin Bae]; Kim, SH[Kim, Sang-Hyun]; Jeong, JO[Jeong, Jin-Ok]; Bae, JH[Bae, Jang-Ho]; Kim, BO[Kim, Byung Ok]; Cho, JH[Cho, Jang Hyun]; Suh, IW[Suh, Il-Woo]; Kim, DI[Kim, Doo-il]; Park, HK[Park, Hoon-Ki]; Park, JS[Park, Jong-Seon]; Choi, WG[Choi, Woong Gil]; Lee, WS[Lee, Wang Soo]; Choi, KH[Choi, Ki Hong]; Park, TK[Park, Taek Kyu]; Lee, JM[Lee, Joo Myung]; Yang, JH[Yang, Jeong Hoon]; Choi, JH[Choi, Jin-Ho]; Choi, SH[Choi, Seung-Hyuk]; Gwon, HC[Gwon, Hyeon-Cheol]; Doh, JH[Doh, Joon-Hyung]; Hahn, JY[Hahn, Joo-Yong]
- Issue Date
- Jun-2021
- Publisher
- JAPANESE CIRCULATION SOC
- Keywords
- Dual antiplatelet therapy; Myocardial infarction; Outcomes
- Citation
- CIRCULATION JOURNAL, v.85, no.6, pp.817 - +
- Indexed
- SCIE
SCOPUS
- Journal Title
- CIRCULATION JOURNAL
- Volume
- 85
- Number
- 6
- Start Page
- 817
- End Page
- +
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/902
- DOI
- 10.1253/circj.CJ-20-0704
- ISSN
- 1346-9843
- Abstract
- Background: The benefits and risks of prolonged dual antiplatelet therapy (DAPT) have not been studied extensively across a broad spectrum of acute coronary syndromes. In this study we investigated whether treatment effects of prolonged DAPT were consistent in patients presenting with ST-segment elevation myocardial infarction (STEMI) vs. non-STEMI (NSTEMI). Methods and Results: As a post hoc analysis of the SMART-DATE trial, effects of >= 12 vs. 6 months DAPT were compared among 1,023 patients presenting with STEMI and 853 NSTEMI patients. The primary outcome was a composite of recurrent myocardial infarction (MI) or stent thrombosis at 18 months after the index procedure. Compared with the 6-month DAPT group, the rate of the composite endpoint was significantly lower in the >= 12-month DAPT group (1.2% vs. 3.8%; hazard ratio [HR] 0.31, 95% confidence interval [CI] 0.12-0.77; P=0.012). The treatment effect of >= 12- vs. 6-month DAPT on the composite endpoint was consistent among NSTEMI patients (0.2% vs. 1.2%, respectively; HR 0.20, 95% CI 0.02-1.70; P=0.140; P-interaction=0.718). In addition, >= 12-month DAPT increased Bleeding Academic Research Consortium (BARC) Type 2-5 bleeding among both STEMI (4.4% vs. 2.0%; HR 2.18, 95% CI 1.03-4.60; P=0.041) and NSTEMI (5.1% vs. 2.2%; HR 2.37, 95% CI 1.08-5.17; P=0.031; P-interaction=0.885) patients. Conclusions: Compared with 6-month DAPT, >= 12-month DAPT reduced recurrent MI or stent thrombosis regardless of the type of MI at presentation.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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