| Literature DB >> 32086787 |
Hirotoshi Watanabe1, Takenori Domei2, Takeshi Morimoto3, Masahiro Natsuaki4, Hiroki Shiomi1, Toshiaki Toyota5, Masanobu Ohya6, Satoru Suwa7, Kensuke Takagi8, Mamoru Nanasato9, Yoshiki Hata10, Masahiro Yagi11, Nobuhiro Suematsu12, Takafumi Yokomatsu13, Itaru Takamisawa9, Masayuki Doi14, Toshiyuki Noda15, Hideki Okayama16, Yoshitane Seino17, Tomohisa Tada18, Hiroki Sakamoto18, Kiyoshi Hibi19, Mitsuru Abe20, Kazuya Kawai21, Koichi Nakao22, Kenji Ando2, Kengo Tanabe23, Yuji Ikari24, Keiichi Igarashi Hanaoka25, Yoshihiro Morino26, Ken Kozuma27, Kazushige Kadota6, Yutaka Furukawa5, Yoshihisa Nakagawa28, Takeshi Kimura29.
Abstract
Previously we briefly reported the effect of 1-month dual antiplatelet therapy (DAPT) for patients with high bleeding risk (HBR) receiving percutaneous coronary intervention (PCI) in the STOPDAPT-2 trial, but full analysis data have not been available. We conducted post hoc subgroup analysis regarding the effect of very short DAPT for HBR patients in STOPDAPT-2 trial. The primary endpoint was a 1-year composite of cardiovascular (cardiovascular death, myocardial infarction, definite stent thrombosis, or stroke) and bleeding (TIMI major/minor bleeding) outcomes. Major secondary endpoints were 1-year cardiovascular composite endpoint and bleeding endpoint. HBR was defined by the academic research consortium (ARC) HBR criteria. Among the 3009 study patients, 1054 (35.0%) were classified as HBR and 1955 (65.0%) were as non-HBR. There were no significant interactions between HBR/non-HBR subgroups and the assigned DAPT group on the primary endpoint (HBR; 3.48% vs. 5.98%, HR 0.57, 95% CI 0.32-1.03, and non-HBR; 1.81% vs. 2.36%, HR 0.78, 95% CI 0.42-1.45; P for interaction = 0.48), the major secondary cardiovascular endpoint (HBR; 3.07% vs. 4.03%, HR 0.77, 95% CI 0.40-1.48, and non-HBR; 1.41% vs. 1.61%, HR 0.89, 95% CI 0.43-1.84; P for interaction = 0.77), and the major secondary bleeding endpoint (HBR; 0.41% vs. 2.71%, HR 0.15, 95% CI 0.03-0.65, and non-HBR; 0.40% vs. 0.85%, HR 0.48, 95% CI 0.14-1.58; P for interaction = 0.22). In conclusion, the effects of 1-month DAPT for the primary and major secondary endpoints were consistent in HBR and non-HBR patients without any significant interactions. The benefit of 1-month DAPT in reducing major bleeding was numerically greater in HBR patients.Clinical trial registration Short and optimal duration of dual antiplatelet therapy after everolimus-eluting cobalt-chromium stent-2 [STOPDAPT-2]; NCT02619760.Entities:
Keywords: Antiplatelet therapy; Bleeding; Coronary stent; High bleeding risk; Percutaneous coronary intervention
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Year: 2020 PMID： 32086787 DOI： 10.1007/s12928-020-00651-9
Source DB: PubMed Journal: Cardiovasc Interv Ther ISSN： 1868-4297