Benefit of Prolonged Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stent for Coronary Bifurcation Lesions Results From the Coronary Bifurcation Stenting Registry II
- Authors
- Jang, Woo Jin; Ahn, Sung Gyun; Song, Young Bin; Choi, Seung-Hyuk; Chun, Woo Jung; Oh, Ju Hyeon; Cho, Sung Woo; Kim, Bum Sung; Yoon, Jung Han; Koo, Bon-Kwon; Yu, Cheol Woong; Jang, Yang Soo; Tahk, Seung-Jea; Kim, Hyo-Soo; Gwon, Hyeon-Cheol; Lee, Sung Yun; Hahn, Joo-Yong
- Issue Date
- 7월-2018
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- drug-eluting stents; incidence; myocardial infarction; percutaneous coronary intervention; thrombosis
- Citation
- CIRCULATION-CARDIOVASCULAR INTERVENTIONS, v.11, no.7
- Indexed
- SCIE
SCOPUS
- Journal Title
- CIRCULATION-CARDIOVASCULAR INTERVENTIONS
- Volume
- 11
- Number
- 7
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/74834
- DOI
- 10.1161/CIRCINTERVENTIONS.117.005849
- ISSN
- 1941-7640
- Abstract
- BACKGROUND: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain. METHODS AND RESULTS: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT >= 12-month group (n=1776) and DAPT <12-month group (n=306). Primary outcome was all-cause death or MI. At 4 years after the index procedure, death or MI occurred less frequently in the DAPT >= 12-month group than the DAPT <12-month group (2.8% versus 12.3%; adjusted hazard ratio, 0.21; 95% confidence interval, 0.13-0.35; P<0.001). After propensity score matching, incidence of death or MI was still lower in the DAPT >= 12-month group than the DAPT <12-month group (2.6% versus 12.3%; adjusted hazard ratio, 0.22; 95% confidence interval, 0.12-0.38; P<0.001). In subgroup analysis, the treatment effect of prolonged DAPT was consistent across subgroups regardless of lesion location, stenting technique, or type of used drug-eluting stent. CONCLUSIONS: The risk of all-cause death or MI was significantly lower in the >= 12-month DAPT group than the <12-month DAPT group after percutaneous coronary intervention for bifurcation lesion using drug-eluting stent. Our results suggest that prolonged DAPT may improve long-term clinical outcomes after percutaneous coronary intervention for bifurcation lesions.
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