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1-Month Dual-Antiplatelet Therapy Followed by Aspirin Monotherapy After Polymer-Free Drug-Coated Stent Implantation: One-Month DAPT Trial

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Author(s)
Sung-Jin HongJung-Sun KimSoon Jun HongDo-Sun LimSeung-Yul LeeKyeong Ho YunJong-Kwan ParkWoong Chol KangYong Hoon KimHyuck-Jun YoonHoyoun WonChung-Mo NamChul-Min AhnByeong-Keuk KimYoung-Guk KoDonghoon ChoiYangsoo JangMyeong-Ki Hong
Keimyung Author(s)
Yoon, Hyuck Jun
Department
Dept. of Internal Medicine (내과학)
Journal Title
JACC Cardiovasc Interv
Issued Date
2021
Volume
14
Issue
16
Keyword
antiplatelet therapydrug-eluting stent(s)percutaneous coronary intervention
Abstract
Objectives:
The aim of this study was to determine whether 1 month of dual-antiplatelet therapy (DAPT) followed by aspirin monotherapy after polymer-free drug-coated stent (PF-DCS) implantation is noninferior to 6 to 12 months of DAPT after biodegradable-polymer drug-eluting stent (BP-DES) implantation.

Background:
It is necessary to determine the optimal minimal duration of DAPT followed by aspirin monotherapy after percutaneous coronary intervention (PCI).

Methods:
In this trial, 3,020 patients with coronary artery disease considered for PCI for noncomplex lesions were randomized to 1-month DAPT after PF-DCS (n = 1,507) or 6- to 12-month DAPT after BP-DES (n = 1,513). The primary endpoint was the 1-year composite of cardiac death, nonfatal myocardial infarction, target vessel revascularization, stroke, or major bleeding (noninferiority hypothesis margin of 3%).

Results:
The primary endpoint occurred in 88 patients (5.9%) in the 1-month DAPT after PF-DCS group and 98 patients (6.5%) in the 6- to 12-month DAPT after BP-DES group (absolute difference −0.7%; upper limit of 1-sided 97.5% confidence interval: 1.33%; P < 0.001 for noninferiority). The occurrence of major bleeding was not different (1.7% vs 2.5%; P = 0.136). There was no difference in the occurrence of stent thrombosis (0.7% vs 0.8%; P = 0.842).

Conclusions:
Among patients who underwent PCI for noncomplex lesions, 1-month DAPT followed by aspirin monotherapy after PF-DCS implantation was noninferior to 6- to 12-month DAPT after BP-DES implantation for the 1-year composite of cardiovascular events or major bleeding. The present findings need to be interpreted in the setting of different types of stents according to antiplatelet strategy. (A Randomized Controlled Comparison Between One Versus More Than Six Months of Dual Antiplatelet Therapy After Biolimus A9-Eluting Stent Implantation; NCT02513810)
Keimyung Author(s)(Kor)
윤혁준
Publisher
School of Medicine (의과대학)
Citation
Sung-Jin Hong et al. (2021). 1-Month Dual-Antiplatelet Therapy Followed by Aspirin Monotherapy After Polymer-Free Drug-Coated Stent Implantation: One-Month DAPT Trial. JACC Cardiovasc Interv, 14(16), 1801–1811. doi: 10.1016/j.jcin.2021.06.003
Type
Article
ISSN
1936-8798
Source
https://www.sciencedirect.com/science/article/pii/S1936879821010451
DOI
10.1016/j.jcin.2021.06.003
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43969
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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