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.

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
Co-first
;
Francesco Bruno;Andrea Saglietto;Mario Iannaccone;Enrico Cerrato;Alessandra Truffa Giachet;Guglielmo Gallone;Federico Conrotto;Iacopo Colonnelli;Gaetano Maria de Ferrari;Fabrizio D'Ascenzo
Co-last
2021

Abstract

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.
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Ovidio De Filippo, Jeehoon Kang, Francesco Bruno, Jung-Kyu Han, Andrea Saglietto, Han-Mo Yang, Giuseppe Patti, Kyung-Woo Park, Radoslaw Parma, Hyo-Soo Kim, Leonardo De Luca, Hyeon-Cheol Gwon, Mario Iannaccone, Woo Jung Chun, Grzegorz Smolka, Seung-Ho Hur, Enrico Cerrato, Seung Hwan Han, Carlo di Mario, Young Bin Song, Javier Escaned, Ki Hong Choi, Gerard Helft, Joon-Hyung Doh, Alessandra Truffa Giachet, Soon-Jun Hong, Saverio Muscoli, Chang-Wook Nam, Guglielmo Gallone, Davide Capodanno, Daniela Trabattoni, Yoichi Imori, Veronica Dusi, Bernardo Cortese, Antonio Montefusco, Federico Conrotto, Iacopo Colonnelli, Imad Sheiban, Gaetano Maria de Ferrari, Bon-Kwon Koo, Fabrizio D'Ascenzo
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1800903
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