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Impact of dual antiplatelet therapy duration on clinical outcome after coronary bifurcation stenting: results from the euro bifurcation club registry
Cirillo, Plinio; Serafino, Luigi DI; Gamra, Habib; Zimarino, Marco; Barbato, Emanuele; Briguori, Carlo; Amat-Santos, Ignatio J; Chieffo, Alaide; Erglis, Andrejs; Gil, Robert J; Kedev, Sasko A; Petrov, Ivo; Radico, Francesco; Niglio, Tullio; Nakamura, Sunao; Costa, Ricardo A; Kanic, Vojko; Perfetti, Matteo; Pellicano, Mariano; Maric, Kristina; Tesorio, Tullio; Vukcevic, Vladan; Esposito, Giovanni; Stankovic, Goran.
Afiliação
  • Cirillo, Plinio; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples. Naples. IT
  • Serafino, Luigi DI; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples. Naples. IT
  • Gamra, Habib; Cardiology Department, Fattouma Bourguiba Hospital, University of Monastir. Monastor. TN
  • Zimarino, Marco; Institute of Cardiology G. d'Annunzio University. Interventional Cath Lab, ASL 2 Abruzzo. Chieti. IT
  • Barbato, Emanuele; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples. Cardiovascular Center Aalst, OLV Clinic. Naples. IT
  • Briguori, Carlo; Interventional Cardiology Unit, Clinica Mediterranea. Naples. IT
  • Amat-Santos, Ignatio J; CIBERCV, Hospital Clínico Universitario de Valladolid. Valladolid. ES
  • Chieffo, Alaide; Interventional Cardiology Unit, San Raffaele Scientific Institute. Milan. IT
  • Erglis, Andrejs; Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital. Riga. LV
  • Gil, Robert J; Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior. Warsaw. PL
  • Kedev, Sasko A; University Clinic of Cardiology Skopje. Skopje. MK
  • Petrov, Ivo; City Clinic. Sofia. BG
  • Radico, Francesco; Institute of Cardiology G. d'Annunzio University. Chieti. IT
  • Niglio, Tullio; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples. Naples. IT
  • Nakamura, Sunao; Department of Cardiology, New Tokyo Hospital. Chiba. JP
  • Costa, Ricardo A; Instituto Dante Pazzanese de Cardiologia. São Paulo. BR
  • Kanic, Vojko; Department of Cardiology and Angiology, University Medical Centre. Maribor. SI
  • Perfetti, Matteo; Interventional Cath Lab, ASL 2 Abruzzo. Chieti. IT
  • Pellicano, Mariano; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples. CIBERCV, Hospital Clínico Universitario de Valladolid. Laboratory of Invasive Cardiology, Clinica Montevergine. Naples. IT
  • Maric, Kristina; Department of Cardiovascular Medicine, University Hospital Centre. Zagreb. HR
  • Tesorio, Tullio; Laboratory of Invasive Cardiology, Clinica Montevergine. Avellino. IT
  • Vukcevic, Vladan; Department of Cardiology, Clinical Center of Serbia, University of Belgrade. Belgrade. RS
  • Esposito, Giovanni; Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples. Naples. IT
  • Stankovic, Goran; Department of Cardiology, Clinical Center of Serbia, University of Belgrade. Belgrade. RS
Panminerva med ; Panminerva med;65(1)May. 2022.
Article em En | CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1378104
Biblioteca responsável: BR79.1
ABSTRACT

BACKGROUND:

Optimal duration of Dual Antiplatelet Therapy (DAPT) following percutaneous coronary intervention (PCI) of a bifurcation stenosis is still debated. We evaluated the impact of DAPT duration on clinical outcomes in all-comers patients undergoing bifurcation PCI included in the European Bifurcation Club (EBC) registry.

METHODS:

We enrolled 2284 consecutive patients who completed at least 18 months follow-up. The cumulative occurrence of Major Adverse Cardiac and Cardiovascular Events (MACCE), defined as a composite of overall-death, non-fatal myocardial infarction (MI), target vessel revascularization (TVR) and stroke were evaluated. Bleedings classified as BARC ≥ 3 were evaluated too.

RESULTS:

Patients were divided into 3 groups Short DAPT (<6-months, n=375); Standard DAPT (≥6-months but ≤12-months, n=636); Prolonged DAPT (>12- months, n=1273). At 24 months follow-up MACCE-free survival was significantly lower in Short DAPT patients (Log-Rank 45.23, p for trend <0.001). MACCE occurred less frequently in the Prolonged DAPT group (148 (11.6%)) as compared with both the Short (83 (22.1%) HR0.48 (0.37-0.63), p<0.001) and Standard DAPT groups (137 (21.5%) HR0.51 (0.41-0.65), p<0.001). These differences remain after propensity score adjustment (respectively, HR 0.27 (0.20-0.36) and HR 0.44 (0.34-0.57)). Such finding was consistent in patients presenting with both acute and chronic coronary syndromes. BARC ≥ 3 bleedings were 0.3% in the Standard DAPT, 1.6% in Short and 1.9% in Prolonged DAPT groups.

CONCLUSIONS:

In the "real-world" EBC registry of patients undergoing PCI of coronary artery bifurcation stenosis, a prolonged DAPT duration was associated with a significantly lower risk of MACCE and a potential increased risk of major bleedings.
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Coleções: 06-national / BR Base de dados: CONASS / SES-SP / SESSP-IDPCPROD Assunto principal: Inibidores da Agregação Plaquetária / Intervenção Coronária Percutânea / Duração da Terapia Idioma: En Revista: Panminerva med Ano de publicação: 2022 Tipo de documento: Article
Buscar no Google
Adicionar na Minha BVS
Imprimir
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Coleções: 06-national / BR Base de dados: CONASS / SES-SP / SESSP-IDPCPROD Assunto principal: Inibidores da Agregação Plaquetária / Intervenção Coronária Percutânea / Duração da Terapia Idioma: En Revista: Panminerva med Ano de publicação: 2022 Tipo de documento: Article