지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 597 - 605 (9page)
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초록· 키워드
오류제보하기
Purpose: Although current guidelines recommend the administration of dual antiplatelet therapy (DAPT) for up to 12 months after the implantation of a drug-eluting stent (DES), extended DAPT is frequently used in real-world practice. Materials and Methods: From the Korean Multicenter Angioplasty Team registry, we identified a total of 1414 patients who used DAPT for >3 years after DES implantation (extended-DAPT group) and conducted a landmark analysis at 36 months after the index procedure. We evaluated the determinants for and long-term outcomes of extended DAPT and compared the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE), defined as the composite of all-cause death, myocardial infarction, stent thrombosis, and stroke, between the extended-DAPT group and the guideline-DAPT group [DAPT <1 year after DES implantation (n=1273)]. Results: Multivariate analysis indicated the occurrence of acute coronary syndrome as the most significant clinical determinant of the use of extended DAPT. Bifurcation, stent diameter ≤3.0 mm, total stented length ≥28 mm, and use of first-generation DESs were also significant angiographic and procedural determinants. MACCE rates were similar between the extended-DAPT group and the guideline-DAPT group in crude analysis [hazard ratio (HR), 1.08; 95% confidence interval (CI), 0.69–1.68; p=0.739] and after propensity matching (HR, 1.22; 95% CI, 0.72–2.07; p=0.453). Major bleeding rates were comparable between the two groups. Conclusion: In patients undergoing percutaneous coronary intervention, indefinite use of DAPT does not show superior outcomes to those of guideline-DAPT. Major bleeding rates are also similar.
목차
등록된 정보가 없습니다.
참고문헌 (25)
참고문헌 신청
Gargiulo G / 2017 / State of the art : duration of dual antiplatelet therapy after percutaneous coronary intervention and coronary stent implantation-past, present and future perspectives / EuroIntervention 13:717~733
Levine GN / 2016 / 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease : A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines : An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention, 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease, 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction, 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes, and 2014ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery / Circulation 134:e123~e155
Mauri L / 2014 / Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents / N Engl J Med 371:2155~2166
Kim JS / 2008 / Comparison of sirolimus-eluting stent and paclitaxel-eluting stent for longterm cardiac adverse events in diabetic patients : the Korean Multicenter Angioplasty Team(KOMATE)registry / Catheter Cardiovasc Interv 72:601~607
Cutlip DE / 2007 / Clinical end points in coronary stent trials : a case for standardized definitions / Circulation 115:2344~2351
Levine GN / 2016 / 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease : A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines : An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention, 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease, 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction, 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes, and 2014ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery / Circulation 134:e123~e155
Mauri L / 2014 / Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents / N Engl J Med 371:2155~2166
Kim JS / 2008 / Comparison of sirolimus-eluting stent and paclitaxel-eluting stent for longterm cardiac adverse events in diabetic patients : the Korean Multicenter Angioplasty Team(KOMATE)registry / Catheter Cardiovasc Interv 72:601~607
Cutlip DE / 2007 / Clinical end points in coronary stent trials : a case for standardized definitions / Circulation 115:2344~2351
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