Safety of 3-Month Dual Antiplatelet Therapy After Implantation of Ultrathin Sirolimus-Eluting Stents With Biodegradable Polymer (Orsiro): Results From the SMART-CHOICE Trial
- Authors
- Yun, Kyeong Ho; Lee, Seung-Yul; Cho, Byung Ryul; Jang, Woo Jin; Song, Young Bin; Oh, Ju-Hyeon; Chun, Woo Jung; Park, Yong Hwan; Im, Eul-Soon; Jeong, Jin-Ok; Oh, Seok Kyu; Cho, Deok-Kyu; Lee, Jong-Young; Koh, Young-Youp; Bae, Jang-Whan; Choi, Jae Woong; Lee, Wang Soo; Yoon, Hyuck Jun; Lee, Seung Uk; Cho, Jang Hyun; Choi, Woong Gil; Rha, Seung-Woon; Lee, Joo Myung; Park, Taek Kyu; Yang, Jeong Hoon; Choi, Jin-Ho; Choi, Seung-Hyuck; Lee, Sang Hoon; Gwon, Hyeon-Cheol; Hahn, Joo-Yong
- Issue Date
- 5-1월-2021
- Publisher
- WILEY
- Keywords
- antiplatelet therapy; coronary artery disease; percutaneous coronary intervention
- Citation
- JOURNAL OF THE AMERICAN HEART ASSOCIATION, v.10, no.1, pp.1 - 9
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF THE AMERICAN HEART ASSOCIATION
- Volume
- 10
- Number
- 1
- Start Page
- 1
- End Page
- 9
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/129416
- DOI
- 10.1161/JAHA.120.018366
- ISSN
- 2047-9980
- Abstract
- BACKGROUND: This study sought to investigate the safety of 3-month dual antiplatelet therapy (DAPT) in patients receiving ultrathin sirolimus-eluting stents with biodegradable polymer (Orsiro). METHODS AND RESULTS: The SMART-CHOICE (Smart Angioplasty Research Team: Comparison Between P2Y12 Antagonist Monotherapy vs Dual Anti- platelet Therapy in Patients Undergoing Implantation of Coronary Drug-Eluting Stents) randomized trial compared 3-month DAPT followed by P2Y12 inhibitor monotherapy with 12-month DAPT in 2993 patients undergoing percutaneous coronary intervention. The present analysis was a prespecified subgroup analysis for patients receiving Orsiro stents. As a post hoc analysis, comparisons between Orsiro and everolimus-eluting stents were also done among patients receiving 3-month DAPT. Of 972 patients receiving Orsiro stents, 481 patients were randomly assigned to 3-month DAPT and 491 to 12-month DAPT. At 12 months, the target vessel failure, defined as a composite of cardiac death, target vessel-related myocardial infarction, or target vessel revascularization, occurred in 8 patients (1.7%) in the 3-month DAPT group and in 14 patients (2.9%) in the 12-month DAPT group (hazard ratio [HR], 0.58; 95% CI, 0.24-1.39; P=0.22). In whole population who were randomly assigned to receive 3-month DAPT (n=1495), there was no significant difference in the target vessel failure between the Orsiro group and the everolimus-eluting stent group (n=1014) (1.7% versus 1.8%; HR, 0.96; 95% CI, 0.41-2.22; P=0.92). CONCLUSIONS: In patients receiving Orsiro stents, clinical outcomes at 1 year were similar between the 3-month DAPT followed by P2Y12 inhibitor monotherapy and 12-month DAPT strategies. With 3-month DAPT, there was no significant difference in target vessel failure between Orsiro and everolimus-eluting stents.
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