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Dual antiplatelet therapy after percutaneous coronary intervention for left main coronary artery disease

 Sungsoo Cho  ;  Do-Yoon Kang  ;  Jung-Sun Kim  ;  Duk-Woo Park  ;  In-Soo Kim  ;  Tae Soo Kang  ;  Jung-Min Ahn  ;  Pil Hyung Lee  ;  Soo-Jin Kang  ;  Seung-Whan Lee  ;  Young-Hak Kim  ;  Cheol Whan Lee  ;  Seong-Wook Park  ;  Seung-Jun Lee  ;  Sung-Jin Hong  ;  Chul-Min Ahn  ;  Byeong-Keuk Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong  ;  Seung-Jung Park 
 REVISTA ESPANOLA DE CARDIOLOGIA, Vol.76(4) : 245-252, 2023-04 
Journal Title
Issue Date
Coronary Artery Disease* / complications ; Coronary Artery Disease* / surgery ; Drug Therapy, Combination ; Hemorrhage / chemically induced ; Hemorrhage / complications ; Hemorrhage / epidemiology ; Humans ; Myocardial Infarction* / etiology ; Percutaneous Coronary Intervention* / adverse effects ; Platelet Aggregation Inhibitors / therapeutic use ; Treatment Outcome
Drug-eluting stents ; Dual antiplatelet therapy ; Enfermedad del tronco coronario izquierdo ; Left main coronary artery disease ; Stents farmacoactivos ; Tratamiento antiagregante plaquetario doble
Introduction and objectives: There are scarce data on the optimal duration and prognostic impact of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents for left main coronary artery (LMCA) disease. The aim of this study was to investigate the practice pattern and long-term prognostic effect of DAPT duration in patients undergoing PCI with second-generation drug-eluting stents for LMCA disease. Methods: Using individual patient-level data from the IRIS-MAIN and KOMATE registries, 1827 patients undergoing PCI with second-generation drug-eluting stents for LMCA disease with valid information on DAPT duration were included. The efficacy outcome was major adverse cardiovascular events (MACE, a composite of cardiac death, myocardial infarction, and stent thrombosis) and the safety outcome was TIMI major bleeding. Results: DAPT duration was < 6 months (n = 273), 6 to 12 months (n = 477), 12 to 24 months (n = 637), and >= 24 months (n = 440). The median follow-up duration was 3.9 [interquartile range, 3.01-5.00] years. Prolonged DAPT duration was associated with lower incidences of MACE. In multigroup propensity score analysis, adjusted HR for MACE were significantly higher for DAPT < 6 months and DAPT 6 to 12 months than for DAPT 12 to 24 months (HR, 4.51; 95%CI, 2.96-6.88 and HR 1.92; 95%CI, 1.23-3.00). There was no difference in HR for major bleeding among the assessed groups. Conclusions: DAPT duration following PCI for LMCA disease is highly variable. Although the duration of DAPT should be considered in the context of the clinical situation of each patient, < 12 months of DAPT was associated with higher incidence of MACE. Registration identifiers: NCT01341327; NCT03908463. (c) 2022 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, In-Soo(김인수) ORCID logo https://orcid.org/0000-0003-2801-5514
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Lee, Seung-Jun(이승준) ORCID logo https://orcid.org/0000-0002-9201-4818
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
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