Benefit of prolonged dual antiplatelet therapy after implantation of drug-eluting stent for coronary bifurcation lesions: Results from the coronary bifurcation stenting registry II

Woo Jin Jang, Sung Gyun Ahn, Young Bin Song, Seung Hyuk Choi, Woo Jung Chun, Ju Hyeon Oh, Sung Woo Cho, Bum Sung Kim, Jung Han Yoon, Bon Kwon Koo, Cheol Woong Yu, Yang Soo Jang, Seung Jea Tahk, Hyo Soo Kim, Hyeon Cheol Gwon, Sung Yun Lee, Joo Yong Hahn

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain. METHODS AND RESULTS: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT ≥12-month group (n=1776) and DAPT <12-month group (n=306). Primary outcome was all-cause death or MI. At 4 years after the index procedure, death or MI occurred less frequently in the DAPT ≥12-month group than the DAPT <12-month group (2.8% versus 12.3%; adjusted hazard ratio, 0.21; 95% confidence interval, 0.13-0.35; P<0.001). After propensity score matching, incidence of death or MI was still lower in the DAPT ≥12-month group than the DAPT <12-month group (2.6% versus 12.3%; adjusted hazard ratio, 0.22; 95% confidence interval, 0.12-0.38; P<0.001). In subgroup analysis, the treatment effect of prolonged DAPT was consistent across subgroups regardless of lesion location, stenting technique, or type of used drug-eluting stent. CONCLUSIONS: The risk of all-cause death or MI was significantly lower in the ≥12-month DAPT group than the <12-month DAPT group after percutaneous coronary intervention for bifurcation lesion using drug-eluting stent. Our results suggest that prolonged DAPT may improve long-term clinical outcomes after percutaneous coronary intervention for bifurcation lesions.

Original languageEnglish
Article numbere005849
JournalCirculation: Cardiovascular Interventions
Volume11
Issue number7
DOIs
Publication statusPublished - 2018 Jan 1

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Drug-Eluting Stents
Registries
Myocardial Infarction
Percutaneous Coronary Intervention
Therapeutics
Group Psychotherapy
Cause of Death
Confidence Intervals
Propensity Score
Stents
Thrombosis
Stroke

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Jang, Woo Jin ; Ahn, Sung Gyun ; Song, Young Bin ; Choi, Seung Hyuk ; Chun, Woo Jung ; Oh, Ju Hyeon ; Cho, Sung Woo ; Kim, Bum Sung ; Yoon, Jung Han ; Koo, Bon Kwon ; Yu, Cheol Woong ; Jang, Yang Soo ; Tahk, Seung Jea ; Kim, Hyo Soo ; Gwon, Hyeon Cheol ; Lee, Sung Yun ; Hahn, Joo Yong. / Benefit of prolonged dual antiplatelet therapy after implantation of drug-eluting stent for coronary bifurcation lesions : Results from the coronary bifurcation stenting registry II. In: Circulation: Cardiovascular Interventions. 2018 ; Vol. 11, No. 7.
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title = "Benefit of prolonged dual antiplatelet therapy after implantation of drug-eluting stent for coronary bifurcation lesions: Results from the coronary bifurcation stenting registry II",
abstract = "BACKGROUND: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain. METHODS AND RESULTS: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT ≥12-month group (n=1776) and DAPT <12-month group (n=306). Primary outcome was all-cause death or MI. At 4 years after the index procedure, death or MI occurred less frequently in the DAPT ≥12-month group than the DAPT <12-month group (2.8{\%} versus 12.3{\%}; adjusted hazard ratio, 0.21; 95{\%} confidence interval, 0.13-0.35; P<0.001). After propensity score matching, incidence of death or MI was still lower in the DAPT ≥12-month group than the DAPT <12-month group (2.6{\%} versus 12.3{\%}; adjusted hazard ratio, 0.22; 95{\%} confidence interval, 0.12-0.38; P<0.001). In subgroup analysis, the treatment effect of prolonged DAPT was consistent across subgroups regardless of lesion location, stenting technique, or type of used drug-eluting stent. CONCLUSIONS: The risk of all-cause death or MI was significantly lower in the ≥12-month DAPT group than the <12-month DAPT group after percutaneous coronary intervention for bifurcation lesion using drug-eluting stent. Our results suggest that prolonged DAPT may improve long-term clinical outcomes after percutaneous coronary intervention for bifurcation lesions.",
author = "Jang, {Woo Jin} and Ahn, {Sung Gyun} and Song, {Young Bin} and Choi, {Seung Hyuk} and Chun, {Woo Jung} and Oh, {Ju Hyeon} and Cho, {Sung Woo} and Kim, {Bum Sung} and Yoon, {Jung Han} and Koo, {Bon Kwon} and Yu, {Cheol Woong} and Jang, {Yang Soo} and Tahk, {Seung Jea} and Kim, {Hyo Soo} and Gwon, {Hyeon Cheol} and Lee, {Sung Yun} and Hahn, {Joo Yong}",
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Benefit of prolonged dual antiplatelet therapy after implantation of drug-eluting stent for coronary bifurcation lesions : Results from the coronary bifurcation stenting registry II. / Jang, Woo Jin; Ahn, Sung Gyun; Song, Young Bin; Choi, Seung Hyuk; Chun, Woo Jung; Oh, Ju Hyeon; Cho, Sung Woo; Kim, Bum Sung; Yoon, Jung Han; Koo, Bon Kwon; Yu, Cheol Woong; Jang, Yang Soo; Tahk, Seung Jea; Kim, Hyo Soo; Gwon, Hyeon Cheol; Lee, Sung Yun; Hahn, Joo Yong.

In: Circulation: Cardiovascular Interventions, Vol. 11, No. 7, e005849, 01.01.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Benefit of prolonged dual antiplatelet therapy after implantation of drug-eluting stent for coronary bifurcation lesions

T2 - Results from the coronary bifurcation stenting registry II

AU - Jang, Woo Jin

AU - Ahn, Sung Gyun

AU - Song, Young Bin

AU - Choi, Seung Hyuk

AU - Chun, Woo Jung

AU - Oh, Ju Hyeon

AU - Cho, Sung Woo

AU - Kim, Bum Sung

AU - Yoon, Jung Han

AU - Koo, Bon Kwon

AU - Yu, Cheol Woong

AU - Jang, Yang Soo

AU - Tahk, Seung Jea

AU - Kim, Hyo Soo

AU - Gwon, Hyeon Cheol

AU - Lee, Sung Yun

AU - Hahn, Joo Yong

PY - 2018/1/1

Y1 - 2018/1/1

N2 - BACKGROUND: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain. METHODS AND RESULTS: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT ≥12-month group (n=1776) and DAPT <12-month group (n=306). Primary outcome was all-cause death or MI. At 4 years after the index procedure, death or MI occurred less frequently in the DAPT ≥12-month group than the DAPT <12-month group (2.8% versus 12.3%; adjusted hazard ratio, 0.21; 95% confidence interval, 0.13-0.35; P<0.001). After propensity score matching, incidence of death or MI was still lower in the DAPT ≥12-month group than the DAPT <12-month group (2.6% versus 12.3%; adjusted hazard ratio, 0.22; 95% confidence interval, 0.12-0.38; P<0.001). In subgroup analysis, the treatment effect of prolonged DAPT was consistent across subgroups regardless of lesion location, stenting technique, or type of used drug-eluting stent. CONCLUSIONS: The risk of all-cause death or MI was significantly lower in the ≥12-month DAPT group than the <12-month DAPT group after percutaneous coronary intervention for bifurcation lesion using drug-eluting stent. Our results suggest that prolonged DAPT may improve long-term clinical outcomes after percutaneous coronary intervention for bifurcation lesions.

AB - BACKGROUND: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain. METHODS AND RESULTS: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT ≥12-month group (n=1776) and DAPT <12-month group (n=306). Primary outcome was all-cause death or MI. At 4 years after the index procedure, death or MI occurred less frequently in the DAPT ≥12-month group than the DAPT <12-month group (2.8% versus 12.3%; adjusted hazard ratio, 0.21; 95% confidence interval, 0.13-0.35; P<0.001). After propensity score matching, incidence of death or MI was still lower in the DAPT ≥12-month group than the DAPT <12-month group (2.6% versus 12.3%; adjusted hazard ratio, 0.22; 95% confidence interval, 0.12-0.38; P<0.001). In subgroup analysis, the treatment effect of prolonged DAPT was consistent across subgroups regardless of lesion location, stenting technique, or type of used drug-eluting stent. CONCLUSIONS: The risk of all-cause death or MI was significantly lower in the ≥12-month DAPT group than the <12-month DAPT group after percutaneous coronary intervention for bifurcation lesion using drug-eluting stent. Our results suggest that prolonged DAPT may improve long-term clinical outcomes after percutaneous coronary intervention for bifurcation lesions.

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U2 - 10.1161/CIRCINTERVENTIONS.117.005849

DO - 10.1161/CIRCINTERVENTIONS.117.005849

M3 - Article

C2 - 30006330

AN - SCOPUS:85058309407

VL - 11

JO - Circulation: Cardiovascular Interventions

JF - Circulation: Cardiovascular Interventions

SN - 1941-7640

IS - 7

M1 - e005849

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