P2Y(12) inhibitor monotherapy in complex percutaneous coronary intervention: A post-hoc analysis of SMART-CHOICE randomized clinical trial
- Authors
- Roh, Ji Woong; Hahn, Joo-Yong; Oh, Ju-Hyeon; Chun, Woo Jung; Park, Yong Hwan; Jang, Woo Jin; Im, Eul-Soon; Jeong, Jin-Ok; Cho, Byung Ryul; Oh, Seok Kyu; Yun, Kyeong Ho; 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; Kim, Hee-Yeol; Lee, Joo Myung; Park, Taek Kyu; Yang, Jeong Hoon; Choi, Jin-Ho; Choi, Seung-Hyuck; Lee, Sang Hoon; Gwon, Hyeon-Cheol; Kim, Dong-Bin; Bin Song, Young
- Issue Date
- Nov-2021
- Publisher
- VIA MEDICA
- Keywords
- clopidogrel; high-risk; percutaneous coronary intervention
- Citation
- CARDIOLOGY JOURNAL, v.28, no.6, pp.855 - 863
- Indexed
- SCIE
SCOPUS
- Journal Title
- CARDIOLOGY JOURNAL
- Volume
- 28
- Number
- 6
- Start Page
- 855
- End Page
- 863
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/140694
- DOI
- 10.5603/CJ.a2021.0101
- ISSN
- 1897-5593
- Abstract
- Background: It remains unclear whether P2Y(12) monotherapy, especially clopidogrel, following short-duration dual antiplatelet therapy (DAPT) is associated with favorable outcomes in patients undergoing complex percutaneous coronary intervention (PCI). Therefore, this study analyzed the efficacy and safety of P2Y(12) inhibitor monotherapy, mostly clopidogrel (78%), in complex PCI following short-term DAPT. Methods: The post-hoc analysis of the SMART-CHOICE trial involving 2,993 patients included 498 cases of complex PCIs, defined by at least one of the following features: 3 vessels treated, >= 3 stents implanted, >= 3 lesions treated, bifurcation with >= 2 stents implanted, and a total stent length of >= 60 mm.The primary end point was major adverse cardiac and cerebrovascular event (MACCE), defined as the composite of all-cause death, myocardial infarction, and stroke. The primary safety endpoint included bleeding, defined as Bleeding Academic Research Consortium (BARC) types 2 to 5. Results: Complex PCI group had a higher risk of MACCE (4.0% vs. 2.3%, hazard ratio [HR] = 1.74,95% confidence interval [CI]: 1.05-2.89, p = 0.033) and a similar risk of BARC types 2-5 bleeding(2.6% vs. 2.6%, HR = 1.02, 95% CI: 0.56-1.86, p = 0.939) compared with those without complex PCIs. Patients undergoing complex PCIs, followed by P2Y(12) inhibitor monotherapy and 12 months of DAPT exhibited similar rates of MACCE (3.8% vs. 4.2%, HR = 0.92, 95% CI: 0.38-2.21, p = 0.853). Conclusions: P2Y(12) inhibitor monotherapy, mostly clopidogrel, following 3 months of DAPT did not increase ischemic events in patients with complex PCIs.
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Collections - Graduate School > Department of Biomedical Sciences > 1. Journal Articles
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