Dual antiplatelet therapy after percutaneous coronary intervention for left main coronary artery disease

Sungsoo Cho, Do Yoon Kang, Jung Sun Kim, Duk Woo Park, In Soo Kim, Tae Soo Kang, Jung Min Ahn, Pil Hyung Lee, Soo Jin Kang, Seung Whan Lee, Young Hak Kim, Cheol Whan Lee, Seong Wook Park, Seung Jun Lee, Sung Jin Hong, Chul Min Ahn, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo JangMyeong Ki Hong, Seung Jung Park

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Introduction and objectives: There are scarce data on the optimal duration and prognostic impact of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents for left main coronary artery (LMCA) disease. The aim of this study was to investigate the practice pattern and long-term prognostic effect of DAPT duration in patients undergoing PCI with second-generation drug-eluting stents for LMCA disease. Methods: Using individual patient-level data from the IRIS-MAIN and KOMATE registries, 1827 patients undergoing PCI with second-generation drug-eluting stents for LMCA disease with valid information on DAPT duration were included. The efficacy outcome was major adverse cardiovascular events (MACE, a composite of cardiac death, myocardial infarction, and stent thrombosis) and the safety outcome was TIMI major bleeding. Results: DAPT duration was < 6 months (n = 273), 6 to 12 months (n = 477), 12 to 24 months (n = 637), and ≥ 24 months (n = 440). The median follow-up duration was 3.9 [interquartile range, 3.01-5.00] years. Prolonged DAPT duration was associated with lower incidences of MACE. In multigroup propensity score analysis, adjusted HR for MACE were significantly higher for DAPT < 6 months and DAPT 6 to 12 months than for DAPT 12 to 24 months (HR, 4.51; 95%CI, 2.96-6.88 and HR 1.92; 95%CI, 1.23-3.00). There was no difference in HR for major bleeding among the assessed groups. Conclusions: DAPT duration following PCI for LMCA disease is highly variable. Although the duration of DAPT should be considered in the context of the clinical situation of each patient, < 12 months of DAPT was associated with higher incidence of MACE. Registration identifiers: NCT01341327; NCT03908463.

Original languageEnglish
Pages (from-to)245-252
Number of pages8
JournalRevista Espanola de Cardiologia
Volume76
Issue number4
DOIs
Publication statusPublished - 2023 Apr

Bibliographical note

Publisher Copyright:
© 2022 Sociedad Española de Cardiología

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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