TY - JOUR
T1 - Real clinical experiences of dual versus triple antithrombotic therapy after percutaneous coronary intervention
AU - Wustrow, Isabel
AU - Sarafoff, Nikolaus
AU - Haller, Bernhard
AU - Rössner, Lisa
AU - Sibbing, Dirk
AU - Schüpke, Stefanie
AU - Ibrahim, Tareq
AU - Anetsberger, Aida
AU - Schunkert, Heribert
AU - Laugwitz, Karl Ludwig
AU - Kastrati, Adnan
AU - Bernlochner, Isabell
N1 - Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Objectives: We aimed to assess the impact of omitting aspirin on clinical outcomes in a real-world collective of patients receiving oral anticoagulation (OAC) therapy who were treated with a current-generation drug-eluting stent (DES) or an everolimus-eluting bioresorbable vascular scaffold (BVS). Background: Limited data are available regarding the clinical benefit of triple antithrombotic therapy (TAT) with aspirin compared with dual antithrombotic therapy (DAT) without aspirin in patients undergoing percutaneous coronary intervention (PCI) and requiring OAC. Methods: In total, 237 patients were analyzed. The primary outcome was a composite of major adverse cardiac and cerebrovascular events (MACCE) within 1 year after PCI. Secondary outcomes were the individual components of the primary endpoint, cardiovascular death, and any bleeding according to Bleeding Academic Research Consortium (BARC) or Thrombolysis in Myocardial Infarction (TIMI) criteria. Results: Eighty-nine patients (37.6%) received DAT, and 148 (62.4%) received TAT. The rate of MACCE was significantly higher in DAT patients than in TAT patients (16 (18%) vs. 11 (7.4%); hazard ratio [HR] 2.73, 95% confidence interval [CI] 1.24–6.03; P = 0.01). The results of the multivariable Cox proportional hazards model including corrections for imbalances in baseline characteristics confirmed a significant independent association between DAT and MACCE (HRadj 3.14, 95% CI 1.31–7.54; P = 0.01). Major bleeding did not differ significantly between treatment groups. Conclusion: DAT was associated with a significantly higher rate of MACCE than TAT after DES or BVS implantation. Further studies are required to evaluate the safety and efficacy of dual versus TAT after PCI in clinical practice.
AB - Objectives: We aimed to assess the impact of omitting aspirin on clinical outcomes in a real-world collective of patients receiving oral anticoagulation (OAC) therapy who were treated with a current-generation drug-eluting stent (DES) or an everolimus-eluting bioresorbable vascular scaffold (BVS). Background: Limited data are available regarding the clinical benefit of triple antithrombotic therapy (TAT) with aspirin compared with dual antithrombotic therapy (DAT) without aspirin in patients undergoing percutaneous coronary intervention (PCI) and requiring OAC. Methods: In total, 237 patients were analyzed. The primary outcome was a composite of major adverse cardiac and cerebrovascular events (MACCE) within 1 year after PCI. Secondary outcomes were the individual components of the primary endpoint, cardiovascular death, and any bleeding according to Bleeding Academic Research Consortium (BARC) or Thrombolysis in Myocardial Infarction (TIMI) criteria. Results: Eighty-nine patients (37.6%) received DAT, and 148 (62.4%) received TAT. The rate of MACCE was significantly higher in DAT patients than in TAT patients (16 (18%) vs. 11 (7.4%); hazard ratio [HR] 2.73, 95% confidence interval [CI] 1.24–6.03; P = 0.01). The results of the multivariable Cox proportional hazards model including corrections for imbalances in baseline characteristics confirmed a significant independent association between DAT and MACCE (HRadj 3.14, 95% CI 1.31–7.54; P = 0.01). Major bleeding did not differ significantly between treatment groups. Conclusion: DAT was associated with a significantly higher rate of MACCE than TAT after DES or BVS implantation. Further studies are required to evaluate the safety and efficacy of dual versus TAT after PCI in clinical practice.
KW - anticoagulants
KW - antiplatelet therapy
KW - coronary artery disease
UR - http://www.scopus.com/inward/record.url?scp=85050946783&partnerID=8YFLogxK
U2 - 10.1002/ccd.27678
DO - 10.1002/ccd.27678
M3 - Article
C2 - 30019824
AN - SCOPUS:85050946783
SN - 1522-1946
VL - 92
SP - 1239
EP - 1246
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 7
ER -