Abstract
BackgroundThe duration of dual antiplatelet therapy (DAPT) after drug-eluting stent implantation in coronary chronic total occlusion (CTO) remains unclear.MethodsWe retrospectively analyzed a total of 512 patients treated with percutaneous coronary intervention (PCI) in the Samsung Medical Center CTO registry. Patients were separated into ≤ 12-month (199, 38.9%) vs. > 12 month (313, 61.1%) based on DAPT duration with aspirin and clopidogrel. The primary outcome was major adverse cardiac and cerebrovascular event (MACCE) during follow-up.ResultsMedian follow-up duration was 67 (interquartile range: 51–84) months. MACCE occurred in 43 patients (21.6%) in the ≤ 12-month and 55 patients (17.6%) in the > 12-month groups. In the propensity-matched population, the rate of MACCE did not differ significantly between the ≤ 12-month and > 12-month group (19.4% vs. 18.8%; hazard ratio [HR], 0.95; 95% confidential interval [CI], 0.52–1.76, p = 0.88). Moreover, moderate or severe bleeding according to BARC criteria (type 2, 3 or 5) was also similar between the ≤ 12-month and > 12-month group (2.5% vs. 1.9%; HR, 1.00; 95% CI, 0.20–4.96, p = 0.99).ConclusionAmong patients treated with PCI for CTO, DAPT with durations of ≤ 12-month showed similar long-term clinical outcomes compared to > 12-month DAPT.
Highlights
Dual antiplatelet therapy (DAPT) with aspirin and P2Y12 receptor inhibitor is recommended for patients undergoing percutaneous coronary intervention (PCI).[1]
Among patients treated with PCI for chronic total occlusion (CTO), DAPT with durations of 12-month showed similar long-term clinical outcomes compared to > 12-month DAPT
The optimal duration of DAPT may differ in patients with coronary chronic total occlusion (CTO) because such patients are at higher risk of ischemic events.[9]
Summary
Dual antiplatelet therapy (DAPT) with aspirin and P2Y12 receptor inhibitor is recommended for patients undergoing percutaneous coronary intervention (PCI).[1]. The optimal duration of DAPT may differ in patients with coronary chronic total occlusion (CTO) because such patients are at higher risk of ischemic events.[9] it has become more common to undergo PCI to treat CTO and the success rates of such treatment have increased, the optimal duration of DAPT after DES implantation in patients with CTO remains unclear.[10,11,12,13] the aim of the present study was to compare long-term clinical outcomes between patients with CTO who were treated with prolonged DAPT and those treated for up to 12 month after PCI with DES. The duration of dual antiplatelet therapy (DAPT) after drug-eluting stent implantation in coronary chronic total occlusion (CTO) remains unclear
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