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Dual Antiplatelet Therapy Beyond 12 Months Versus for 12 Months After Drug-Eluting Stents for Acute Myocardial Infarction

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Affiliated Author(s)
허승호
Alternative Author(s)
Hur, Seung Ho
Journal Title
Journal of cardiology
ISSN
1876-4738
Issued Date
2020
Keyword
Antiplatelet agentsDrug-eluting stentsMyocardial infarction
Abstract
Background:
The optimal duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome remains uncertain. This study investigated the benefit of DAPT beyond 12 months after drug-eluting stents (DES) for acute myocardial infarction (MI).

Methods:
From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 6199 patients treated with DAPT for 12 months after DES (second-generation DES 98%) without ischemic or bleeding events were analyzed. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of death from any cause, MI, or ischemic stroke during the period from 12 to 24 months.

Results:
After adjustment using inverse probability of treatment weighting, patients who received DAPT beyond 12 months ( n = 4795), compared to patients treated with 12-month DAPT ( n = 1404), had a similar incidence of MACCE (1.3% vs. 1.0%, HR: 1.32, 95% CI: 0.71–2.45, p = 0.378). The 2 groups did not differ significantly in the rates of death (0.1% vs. 0.1%), MI (0.8% vs.0.6%), stent thrombosis (0.1% vs. 0.2%), ischemic stroke (0.4% vs. 0.2%), and major bleeding (0.1% vs. 0.1%). The rate of net adverse clinical events was 1.4% with DAPT beyond 12 months and 1.1% with 12-month DAPT ( p = 0.466).

Conclusions:
DAPT beyond 12 months, as compared with 12-month DAPT, in real-world patients with acute MI treated predominantly with second-generation DES did not reduce the risk of MACCE. The rates of major bleeding and net adverse clinical events did not differ significantly between the 2 treatments.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine (의과대학)
Citation
Doo Sun Sim et al. (2020). Dual Antiplatelet Therapy Beyond 12 Months Versus for 12 Months After Drug-Eluting Stents for Acute Myocardial Infarction. Journal of cardiology, 75(1), 66–73. doi: 10.1016/j.jjcc.2019.06.006
Type
Article
ISSN
1876-4738
DOI
10.1016/j.jjcc.2019.06.006
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42354
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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