Sungsoo Cho1, Yong-Joon Lee2, Young-Guk Ko3, Tae Soo Kang4, Seong-Hoon Lim1, Sung-Jin Hong2, Chul-Min Ahn2, Jung-Sun Kim2, Byeong-Keuk Kim2, Donghoon Choi2, Myeong-Ki Hong2, Yangsoo Jang2. 1. Division of Cardiovascular Medicine, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan-si, Choongcheongnam-do, Korea. 2. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. 3. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. Electronic address: ygko@yuhs.ac. 4. Division of Cardiovascular Medicine, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan-si, Choongcheongnam-do, Korea. Electronic address: neosoo70@dankook.ac.kr.
Abstract
OBJECTIVES: The aim of this study was to investigate the optimal strategy for antiplatelet therapy in patients with lower extremity peripheral artery disease (PAD) after endovascular revascularization. BACKGROUND: The optimal strategy for antiplatelet therapy in patients with PAD after endovascular revascularization has not been established. METHODS: From March 2008 to February 2013, 693 patients with lower extremity PAD treated with different antiplatelet therapies, such as mono-antiplatelet therapy (MAPT) and dual-antiplatelet therapy (DAPT), of various durations after endovascular revascularization were analyzed. They were classified into 2 groups (DAPT <6 months or MAPT vs. DAPT ≥6 months). The primary outcomes were major adverse cardiovascular events and major adverse limb events. The safety outcome was major bleeding. RESULTS: During 5-year follow-up, major adverse cardiovascular events occurred less frequently in the DAPT ≥6-month group than the DAPT <6-month or MAPT group (17.3% vs. 31.3%; hazard ratio: 0.44; 95% confidence interval: 0.30 to 0.65; p < 0.001). Major adverse limb events also occurred less frequently in the DAPT ≥6-month group than the DAPT <6-month or MAPT group (21.5% vs. 43.7%; hazard ratio: 0.42; 95% CI: 0.30 to 0.58; p < 0.001). However, major bleeding events were infrequent, with no signal toward harm with DAPT ≥6 months. Results were consistent after inverse probability-weighted adjustment and propensity score matching. CONCLUSIONS: Following endovascular revascularization for lower extremity PAD, DAPT ≥6 months was associated with decreased 5-year major adverse cardiovascular events and major adverse limb events.
OBJECTIVES: The aim of this study was to investigate the optimal strategy for antiplatelet therapy in patients with lower extremity peripheral artery disease (PAD) after endovascular revascularization. BACKGROUND: The optimal strategy for antiplatelet therapy in patients with PAD after endovascular revascularization has not been established. METHODS: From March 2008 to February 2013, 693 patients with lower extremity PAD treated with different antiplatelet therapies, such as mono-antiplatelet therapy (MAPT) and dual-antiplatelet therapy (DAPT), of various durations after endovascular revascularization were analyzed. They were classified into 2 groups (DAPT <6 months or MAPT vs. DAPT ≥6 months). The primary outcomes were major adverse cardiovascular events and major adverse limb events. The safety outcome was major bleeding. RESULTS: During 5-year follow-up, major adverse cardiovascular events occurred less frequently in the DAPT ≥6-month group than the DAPT <6-month or MAPT group (17.3% vs. 31.3%; hazard ratio: 0.44; 95% confidence interval: 0.30 to 0.65; p < 0.001). Major adverse limb events also occurred less frequently in the DAPT ≥6-month group than the DAPT <6-month or MAPT group (21.5% vs. 43.7%; hazard ratio: 0.42; 95% CI: 0.30 to 0.58; p < 0.001). However, major bleeding events were infrequent, with no signal toward harm with DAPT ≥6 months. Results were consistent after inverse probability-weighted adjustment and propensity score matching. CONCLUSIONS: Following endovascular revascularization for lower extremity PAD, DAPT ≥6 months was associated with decreased 5-year major adverse cardiovascular events and major adverse limb events.
Authors: E Hope Weissler; Yongfei Wang; Jordan M Gales; Dmitriy N Feldman; Shipra Arya; Eric A Secemsky; Herbert D Aronow; Beau M Hawkins; J Antonio Gutierrez; Manesh R Patel; Jeptha P Curtis; W Schuyler Jones; Rajesh V Swaminathan Journal: J Am Heart Assoc Date: 2022-06-20 Impact factor: 6.106
Authors: Nikhil Singh; Li Ding; Gregory A Magee; David M Shavelle; Vikram S Kashyap; Parveen K Garg Journal: Circ Cardiovasc Interv Date: 2020-08-14 Impact factor: 6.546