Benefit of prolonged dual antiplatelet therapy after implantation of drug-eluting stent for coronary bifurcation lesions: Results from the coronary bifurcation stenting registry II

Woo Jin Jang, Sung Gyun Ahn, Young Bin Song, Seung Hyuk Choi, Woo Jung Chun, Ju Hyeon Oh, Sung Woo Cho, Bum Sung Kim, Jung Han Yoon, Bon Kwon Koo, Cheol Woong Yu, Yang Soo Jang, Seung Jea Tahk, Hyo Soo Kim, Hyeon Cheol Gwon, Sung Yun Lee, Joo Yong Hahn

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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.

Original languageEnglish
Article numbere005849
JournalCirculation: Cardiovascular Interventions
Volume11
Issue number7
DOIs
Publication statusPublished - 2018 Jan 1

Keywords

  • Drug-eluting stents
  • Incidence
  • Myocardial infarction
  • Percutaneous coronary intervention
  • Thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Jang, W. J., Ahn, S. G., Song, Y. B., Choi, S. H., Chun, W. J., Oh, J. H., Cho, S. W., Kim, B. S., Yoon, J. H., Koo, B. K., Yu, C. W., Jang, Y. S., Tahk, S. J., Kim, H. S., Gwon, H. C., Lee, S. Y., & Hahn, J. Y. (2018). Benefit of prolonged dual antiplatelet therapy after implantation of drug-eluting stent for coronary bifurcation lesions: Results from the coronary bifurcation stenting registry II. Circulation: Cardiovascular Interventions, 11(7), [e005849]. https://doi.org/10.1161/CIRCINTERVENTIONS.117.005849