Cited 110 times in
Bleeding-Related Deaths in Relation to the Duration of Dual-Antiplatelet Therapy After Coronary Stenting
DC Field | Value | Language |
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dc.contributor.author | 김병극 | - |
dc.contributor.author | 장양수 | - |
dc.contributor.author | 홍명기 | - |
dc.date.accessioned | 2017-11-02T08:23:44Z | - |
dc.date.available | 2017-11-02T08:23:44Z | - |
dc.date.issued | 2017 | - |
dc.identifier.issn | 0735-1097 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/154418 | - |
dc.description.abstract | BACKGROUND: Although some randomized controlled trials (RCTs) and meta-analyses have suggested that prolonged dual-antiplatelet therapy (DAPT) may be associated with increased mortality, the mechanistic underpinnings of this association remain unclear. OBJECTIVES: The aim of this study was to analyze the associations among bleeding, mortality, and DAPT duration after drug-eluting stent implantation in a meta-analysis of RCTs. METHODS: RCTs comparing different DAPT durations after drug-eluting stent placement were sought through the MEDLINE, Embase, and Cochrane databases and the proceedings of international meetings. Deaths were considered possibly bleeding related if occurring within 1 year of the episodes of bleeding. Primary analysis was by intention-to-treat. Secondary analysis was performed in a modified intention-to-treat population in which events occurring when all patients were on DAPT were excluded. RESULTS: Individual patient data were obtained for 6 RCTs, and aggregate data were available for 12 RCTs. Patients with bleeding had significantly higher rates of mortality compared with those without, and in a time-adjusted multivariate analysis, bleeding was an independent predictor of mortality occurring within 1 year of the bleeding episode (hazard ratio: 6.93; 95% confidence interval: 4.53 to 10.60; p < 0.0001). Shorter DAPT was associated with lower rates of all-cause death compared with longer DAPT (hazard ratio: 0.85; 95% confidence interval: 0.73 to 1.00; p = 0.05), which was driven by lower rates of bleeding-related deaths with shorter DAPT compared with prolonged DAPT (hazard ratio: 0.65; 95% confidence interval: 0.43 to 0.99; p = 0.04). Mortality unrelated to bleeding was comparable between the 2 groups. Similar results were apparent in the modified intention-to-treat population. CONCLUSIONS: Bleeding was strongly associated with the occurrence of mortality within 1 year after the bleeding event. Shorter compared with longer DAPT was associated with lower risk for bleeding-related death, a finding that may underlie the lower all-cause mortality with shorter DAPT in the RCTs of different DAPT durations after DES. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Elsevier Biomedical | - |
dc.relation.isPartOf | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Drug-Eluting Stents | - |
dc.subject.MESH | Hemorrhage/chemically induced* | - |
dc.subject.MESH | Hemorrhage/mortality | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Percutaneous Coronary Intervention | - |
dc.subject.MESH | Platelet Aggregation Inhibitors/administration & dosage | - |
dc.subject.MESH | Platelet Aggregation Inhibitors/adverse effects* | - |
dc.subject.MESH | Postoperative Complications/chemically induced* | - |
dc.subject.MESH | Postoperative Complications/mortality | - |
dc.subject.MESH | Randomized Controlled Trials as Topic | - |
dc.title | Bleeding-Related Deaths in Relation to the Duration of Dual-Antiplatelet Therapy After Coronary Stenting | - |
dc.type | Article | - |
dc.publisher.location | United States | - |
dc.contributor.college | College of Medicine | - |
dc.contributor.department | Dept. of Internal Medicine | - |
dc.contributor.googleauthor | Tullio Palmerini | - |
dc.contributor.googleauthor | Letizia Bacchi Reggiani | - |
dc.contributor.googleauthor | Diego Della Riva | - |
dc.contributor.googleauthor | Mattia Romanello | - |
dc.contributor.googleauthor | Fausto Feres | - |
dc.contributor.googleauthor | Alexandre Abizaid | - |
dc.contributor.googleauthor | Martine Gilard | - |
dc.contributor.googleauthor | Marie-Claude Morice | - |
dc.contributor.googleauthor | Marco Valgimigli | - |
dc.contributor.googleauthor | Myeong-Ki Hong | - |
dc.contributor.googleauthor | Byeong-Keuk Kim | - |
dc.contributor.googleauthor | Yangsoo Jang | - |
dc.contributor.googleauthor | Hyo-Soo Kim | - |
dc.contributor.googleauthor | Kyung Woo Park | - |
dc.contributor.googleauthor | Antonio Colombo | - |
dc.contributor.googleauthor | Alaide Chieffo | - |
dc.contributor.googleauthor | Jung-Min Ahn | - |
dc.contributor.googleauthor | Seung-Jung Park | - |
dc.contributor.googleauthor | Stefanie Schüpke | - |
dc.contributor.googleauthor | Adnan Kastrati | - |
dc.contributor.googleauthor | Gilles Montalescot | - |
dc.contributor.googleauthor | Philippe Gabriel Steg | - |
dc.contributor.googleauthor | Abdourahmane Diallo | - |
dc.contributor.googleauthor | Eric Vicaut | - |
dc.contributor.googleauthor | Gerard Helft | - |
dc.contributor.googleauthor | Giuseppe Biondi-Zoccai | - |
dc.contributor.googleauthor | Bo Xu | - |
dc.contributor.googleauthor | Yaling Han | - |
dc.contributor.googleauthor | Philippe Genereux | - |
dc.contributor.googleauthor | Deepak L. Bhatt | - |
dc.contributor.googleauthor | Gregg W. Stone | - |
dc.identifier.doi | 10.1016/j.jacc.2017.02.029 | - |
dc.contributor.localId | A03448 | - |
dc.contributor.localId | A04391 | - |
dc.contributor.localId | A00493 | - |
dc.relation.journalcode | J01770 | - |
dc.identifier.eissn | 1558-3597 | - |
dc.identifier.pmid | 28427576 | - |
dc.identifier.url | http://www.sciencedirect.com/science/article/pii/S0735109717306964 | - |
dc.subject.keyword | drug-eluting stent | - |
dc.subject.keyword | dual antiplatelet therapy | - |
dc.subject.keyword | mortality | - |
dc.contributor.alternativeName | Kim, Byeong Keuk | - |
dc.contributor.alternativeName | Jang, Yang Soo | - |
dc.contributor.alternativeName | Hong, Myeong Ki | - |
dc.contributor.affiliatedAuthor | Jang, Yang Soo | - |
dc.contributor.affiliatedAuthor | Hong, Myeong Ki | - |
dc.contributor.affiliatedAuthor | Kim, Byeong Keuk | - |
dc.citation.title | Journal of the American College of Cardiology | - |
dc.citation.volume | 69 | - |
dc.citation.number | 16 | - |
dc.citation.startPage | 2011 | - |
dc.citation.endPage | 2022 | - |
dc.identifier.bibliographicCitation | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol.69(16) : 2011-2022, 2017 | - |
dc.date.modified | 2017-11-01 | - |
dc.identifier.rimsid | 60825 | - |
dc.type.rims | ART | - |
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