Benefit of Extended Dual Antiplatelet Therapy Duration in Acute Coronary Syndrome Patients Treated with Drug Eluting Stents for Coronary Bifurcation Lesions (from the BIFURCAT Registry)
Ovidio de Filippo
(1)
,
Jeehoon Kang
(2)
,
Francesco Bruno
(1)
,
Jung-Kyu Han
(2)
,
Andrea Saglietto
(1)
,
Han-Mo Yang
(2)
,
Giuseppe Patti
(3)
,
Kyung-Woo Park
(2)
,
Radoslaw Parma
(4)
,
Hyo-Soo Kim
(2)
,
Leonardo de Luca
(5)
,
Hyeon-Cheol Gwon
(6)
,
Mario Iannaccone
(7)
,
Woo Jung Chun
(6)
,
Grzegorz Smolka
(4)
,
Seung-Ho Hur
(8)
,
Enrico Cerrato
(9)
,
Seung Hwan Han
(10)
,
Carlo Di Mario
(11)
,
Young Bin Song
(6)
,
Javier Escaned
(12, 13)
,
Ki Hong Choi
(6)
,
Gerard Helft
(14)
,
Joon-Hyung Doh
(15)
,
Alessandra Truffa Giachet
(16)
,
Soon-Jun Hong
(17)
,
Saverio Muscoli
(18)
,
Chang-Wook Nam
(8)
,
Guglielmo Gallone
(1)
,
Davide Capodanno
(19)
,
Daniela Trabattoni
(20)
,
Yoichi Imori
(21)
,
Veronica Dusi
(22)
,
Bernardo Cortese
(23)
,
Antonio Montefusco
(1)
,
Federico Conrotto
(1)
,
Iacopo Colonnelli
(1)
,
Imad Sheiban
(24)
,
Gaetano Maria de Ferrari
(1)
,
Bon-Kwon Koo
(2)
,
Fabrizio d'Ascenzo
(1)
1
UNITO -
Università degli studi di Torino = University of Turin
2 Seoul National University Hospital
3 University Hospital “Maggiore della Carità” [Novara, Italy]
4 SUM - Medical University of Silesia
5 Ospedale San Camillo-Forlanini
6 Samsung Medical Center Sungkyunkwan University School of Medicine
7 OSGB - Ospedale San Giovanni Bosco [Turin, Italy]
8 Keimyung University
9 Ospedale San Luigi Gonzaga
10 Gachon University Gil Medical Center [Incheon, Republic of Korea]
11 AOUC - Azienda Ospedaliero Universitaria Careggi [Firenze] = Careggi University Hospital [Florence, Italy]
12 IdISSC - Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain]
13 UCM - Universidad Complutense de Madrid = Complutense University of Madrid [Madrid]
14 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
15 Inje University
16 OA - Ospedale di Asti [Asti, Italy]
17 Korea University Anam Hospital [Seoul]
18 Università degli Studi di Roma Tor Vergata [Roma] = University of Rome Tor Vergata
19 AOU Policlinico Vittorio-Emanuele [Catania, Italia]
20 IRCCS Istituto Nazionale dei Tumori [Milano]
21 Nippon Medical School [Tokyo, Japon]
22 UNIPV - Università degli Studi di Pavia = University of Pavia
23 ASST Fatebenefratelli-Sacco [Milan, Italy]
24 CP - Clinica Pederzoli [Peschiera del Garda, Italy]
2 Seoul National University Hospital
3 University Hospital “Maggiore della Carità” [Novara, Italy]
4 SUM - Medical University of Silesia
5 Ospedale San Camillo-Forlanini
6 Samsung Medical Center Sungkyunkwan University School of Medicine
7 OSGB - Ospedale San Giovanni Bosco [Turin, Italy]
8 Keimyung University
9 Ospedale San Luigi Gonzaga
10 Gachon University Gil Medical Center [Incheon, Republic of Korea]
11 AOUC - Azienda Ospedaliero Universitaria Careggi [Firenze] = Careggi University Hospital [Florence, Italy]
12 IdISSC - Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain]
13 UCM - Universidad Complutense de Madrid = Complutense University of Madrid [Madrid]
14 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
15 Inje University
16 OA - Ospedale di Asti [Asti, Italy]
17 Korea University Anam Hospital [Seoul]
18 Università degli Studi di Roma Tor Vergata [Roma] = University of Rome Tor Vergata
19 AOU Policlinico Vittorio-Emanuele [Catania, Italia]
20 IRCCS Istituto Nazionale dei Tumori [Milano]
21 Nippon Medical School [Tokyo, Japon]
22 UNIPV - Università degli Studi di Pavia = University of Pavia
23 ASST Fatebenefratelli-Sacco [Milan, Italy]
24 CP - Clinica Pederzoli [Peschiera del Garda, Italy]
Ovidio de Filippo
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Bon-Kwon Koo
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Résumé
Optimal dual antiplatelet therapy (DAPT) duration for patients undergoing percutaneous coronary intervention (PCI) for coronary bifurcations is an unmet issue. The BIFURCAT registry was obtained by merging two registries on coronary bifurcations. Three groups were compared in a two-by-two fashion: short-term DAPT (≤ 6 months), intermediate-term DAPT (6-12 months) and extended DAPT (>12 months). Major adverse cardiac events (MACE) (a composite of all-cause death, myocardial infarction (MI), target-lesion revascularization and stent thrombosis) were the primary endpoint. Single components of MACE were the secondary endpoints. Events were appraised according to the clinical presentation: chronic coronary syndrome (CCS) versus acute coronary syndrome (ACS). 5537 patients (3231 ACS, 2306 CCS) were included. After a median follow-up of 2.1 years (IQR 0.9-2.2), extended DAPT was associated with a lower incidence of MACE compared with intermediate-term DAPT (2.8% versus 3.4%, adjusted HR 0.23 [0.1-0.54], p <0.001), driven by a reduction of all-cause death in the ACS cohort. In the CCS cohort, an extended DAPT strategy was not associated with a reduced risk of MACE. In conclusion, among real-world patients receiving PCI for coronary bifurcation, an extended DAPT strategy was associated with a reduction of MACE in ACS but not in CCS patients.
Domaines
Sciences du Vivant [q-bio]
Origine : Publication financée par une institution