Sriraag Balaji Srinivasan1,2, Amro Sehly1, Biyanka Jaltotage1, Simon Qin3, Abdul Rahman Ihdayhid1,4,5, James Marangou1,6, James M Rankin1, Frank M Sanfilippo3, Girish Dwivedi7,8,9. 1. Department of Cardiology, Fiona Stanley Hospital, Perth, WA, Australia. 2. School of Medicine, University of Western Australia, Perth, WA, Australia. 3. School of Population and Global Health, University of Western Australia, Perth, WA, Australia. 4. Harry Perkins Institute of Medical Research, Perth, WA, Australia. 5. Medical School, Curtin University, Perth, WA, Australia. 6. Menzies School of Health Research, Darwin, NT, Australia. 7. Department of Cardiology, Fiona Stanley Hospital, Perth, WA, Australia. girish.dwivedi@perkins.uwa.edu.au. 8. School of Medicine, University of Western Australia, Perth, WA, Australia. girish.dwivedi@perkins.uwa.edu.au. 9. Harry Perkins Institute of Medical Research, Perth, WA, Australia. girish.dwivedi@perkins.uwa.edu.au.
Abstract
BACKGROUND: Optimal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) remains controversial. AIM: We investigated the relationship between DAPT duration following PCI and long-term ischemic and bleeding outcomes under real-world conditions. METHODS: Patients aged ≥ 65 years who underwent PCI with stenting in Western Australian hospitals between 2003 and 2008 and survived 2 years were identified from linked hospital admissions data. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE) defined as a composite of all-cause death and admissions for acute coronary syndrome (ACS), coronary artery revascularization procedure, stroke, and major bleeding. Secondary outcomes were ACS admissions, all-cause death, and major bleeding admissions. Patients were followed up for 5 years from initial PCI. RESULTS: A total of 3963 patients were included in the final analysis. The mean age of the cohort was 74.5 ± 6.1 years with 67.3% males. No significant difference was seen with 6-12, 12-18, or 18-24 months DAPT, compared to 0-6 months DAPT duration for MACCE and all secondary outcomes at 3- and 5-year post-PCI. CONCLUSION: There is no significant difference in both bleeding and ischemic outcomes in long-term DAPT as compared to short-term DAPT for first- and second-generation drug-eluting stents in a real-world population.
BACKGROUND: Optimal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) remains controversial. AIM: We investigated the relationship between DAPT duration following PCI and long-term ischemic and bleeding outcomes under real-world conditions. METHODS: Patients aged ≥ 65 years who underwent PCI with stenting in Western Australian hospitals between 2003 and 2008 and survived 2 years were identified from linked hospital admissions data. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE) defined as a composite of all-cause death and admissions for acute coronary syndrome (ACS), coronary artery revascularization procedure, stroke, and major bleeding. Secondary outcomes were ACS admissions, all-cause death, and major bleeding admissions. Patients were followed up for 5 years from initial PCI. RESULTS: A total of 3963 patients were included in the final analysis. The mean age of the cohort was 74.5 ± 6.1 years with 67.3% males. No significant difference was seen with 6-12, 12-18, or 18-24 months DAPT, compared to 0-6 months DAPT duration for MACCE and all secondary outcomes at 3- and 5-year post-PCI. CONCLUSION: There is no significant difference in both bleeding and ischemic outcomes in long-term DAPT as compared to short-term DAPT for first- and second-generation drug-eluting stents in a real-world population.
Authors: Laura Mauri; Dean J Kereiakes; Robert W Yeh; Priscilla Driscoll-Shempp; Donald E Cutlip; P Gabriel Steg; Sharon-Lise T Normand; Eugene Braunwald; Stephen D Wiviott; David J Cohen; David R Holmes; Mitchell W Krucoff; James Hermiller; Harold L Dauerman; Daniel I Simon; David E Kandzari; Kirk N Garratt; David P Lee; Thomas K Pow; Peter Ver Lee; Michael J Rinaldi; Joseph M Massaro Journal: N Engl J Med Date: 2014-11-16 Impact factor: 91.245
Authors: Martine Gilard; Paul Barragan; Arif A L Noryani; Hussam A Noor; Talib Majwal; Thomas Hovasse; Philippe Castellant; Michel Schneeberger; Luc Maillard; Erwan Bressolette; Jaroslaw Wojcik; Nicolas Delarche; Didier Blanchard; Bernard Jouve; Olivier Ormezzano; Franck Paganelli; Gilles Levy; Joël Sainsous; Didier Carrie; Alain Furber; Jacques Berland; Oliver Darremont; Hervé Le Breton; Anne Lyuycx-Bore; Antoine Gommeaux; Claude Cassat; Alain Kermarrec; Pierre Cazaux; Philippe Druelles; Raphael Dauphin; Jean Armengaud; Patrick Dupouy; Didier Champagnac; Patrick Ohlmann; Knut Endresen; Hakim Benamer; Robert Gabor Kiss; Imre Ungi; Jacques Boschat; Marie-Claude Morice Journal: J Am Coll Cardiol Date: 2014-11-16 Impact factor: 24.094
Authors: Marc P Bonaca; Deepak L Bhatt; Marc Cohen; Philippe Gabriel Steg; Robert F Storey; Eva C Jensen; Giulia Magnani; Sameer Bansilal; M Polly Fish; Kyungah Im; Olof Bengtsson; Ton Oude Ophuis; Andrzej Budaj; Pierre Theroux; Mikhail Ruda; Christian Hamm; Shinya Goto; Jindrich Spinar; José Carlos Nicolau; Robert G Kiss; Sabina A Murphy; Stephen D Wiviott; Peter Held; Eugene Braunwald; Marc S Sabatine Journal: N Engl J Med Date: 2015-03-14 Impact factor: 91.245
Authors: Anda Bularga; Mohammed N Meah; Dimitrios Doudesis; Anoop S V Shah; Nicholas L Mills; David E Newby; Kuan Ken Lee Journal: Open Heart Date: 2021-07