Optimal duration of DAPT after second-generation drug-eluting stent in acute coronary syndrome

Ji Yong Jang, Dong Ho Shin, Jung Sun Kim, Sung Jin Hong, Chul Min Ahn, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Kyung Woo Park, Hyeon Cheol Gwon, Hyo Soo Kim, Yangsoo Jang

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background We evaluated optimal duration of dual antiplatelet therapy (DAPT) after second-generation drug-eluting stent (DES) implantation in acute coronary syndrome (ACS). Material and methods From pooled analysis of three randomized clinical trials (EXCELLENT, IVUS-XPL, RESET), a total of 2,216 patient with ACS undergoing second-generation DES implantation were selected. Each study randomized patients to a short-duration DAPT arm (n = 1119; 6 months) or a standard-duration DAPT arm (n = 1097; 12 months). Two-thirds of patients were male, and their mean age was 63 years. Mean DAPT durations were 164 ±76 and 359 ±68 days, respectively. The primary endpoint was composite of cardiac death, myocardial infarction, stent thrombosis, stroke or major bleeding during the first 12 months after implantation, analyzed according to the intention-to-treat population. Results Demographic characteristics were balanced between groups. Mean DAPT duration was 164 and 359 days, respectively. Primary endpoint occurred in 22 patients with short-DAPT and 21 patients with standard-DAPT (2.0% versus 1.9%; hazard ratio [HR] 1.03; 95% confidence interval [CI] 0.56–1.86; p = 0.94). Landmark analysis after six-months, no significant difference in primary endpoint between short and standard duration DAPT (1.0% versus 0.8%; HR 1.22; 95% CI 0.51–2.95; p = 0.66). Conclusions Short-duration DAPT (6 months) demonstrated a similar incidence of net adverse cardiovascular and clinical events at 12 months after second-generation DES in ACS compared with standard duration DAPT (12 months).

Original languageEnglish
Article numbere0207386
JournalPloS one
Volume13
Issue number11
DOIs
Publication statusPublished - 2018 Nov

Fingerprint

Drug-Eluting Stents
Stents
Acute Coronary Syndrome
drugs
therapeutics
duration
Pharmaceutical Preparations
Hazards
endpoints
Therapeutics
confidence interval
Confidence Intervals
Composite materials
randomized clinical trials
sociodemographic characteristics
myocardial infarction
thrombosis
stroke
hemorrhage
Thrombosis

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Jang, Ji Yong ; Shin, Dong Ho ; Kim, Jung Sun ; Hong, Sung Jin ; Ahn, Chul Min ; Kim, Byeong Keuk ; Ko, Young Guk ; Choi, Donghoon ; Hong, Myeong Ki ; Park, Kyung Woo ; Gwon, Hyeon Cheol ; Kim, Hyo Soo ; Jang, Yangsoo. / Optimal duration of DAPT after second-generation drug-eluting stent in acute coronary syndrome. In: PloS one. 2018 ; Vol. 13, No. 11.
@article{7de88d6a376d4a3a83de94f0559bf1a6,
title = "Optimal duration of DAPT after second-generation drug-eluting stent in acute coronary syndrome",
abstract = "Background We evaluated optimal duration of dual antiplatelet therapy (DAPT) after second-generation drug-eluting stent (DES) implantation in acute coronary syndrome (ACS). Material and methods From pooled analysis of three randomized clinical trials (EXCELLENT, IVUS-XPL, RESET), a total of 2,216 patient with ACS undergoing second-generation DES implantation were selected. Each study randomized patients to a short-duration DAPT arm (n = 1119; 6 months) or a standard-duration DAPT arm (n = 1097; 12 months). Two-thirds of patients were male, and their mean age was 63 years. Mean DAPT durations were 164 ±76 and 359 ±68 days, respectively. The primary endpoint was composite of cardiac death, myocardial infarction, stent thrombosis, stroke or major bleeding during the first 12 months after implantation, analyzed according to the intention-to-treat population. Results Demographic characteristics were balanced between groups. Mean DAPT duration was 164 and 359 days, respectively. Primary endpoint occurred in 22 patients with short-DAPT and 21 patients with standard-DAPT (2.0{\%} versus 1.9{\%}; hazard ratio [HR] 1.03; 95{\%} confidence interval [CI] 0.56–1.86; p = 0.94). Landmark analysis after six-months, no significant difference in primary endpoint between short and standard duration DAPT (1.0{\%} versus 0.8{\%}; HR 1.22; 95{\%} CI 0.51–2.95; p = 0.66). Conclusions Short-duration DAPT (6 months) demonstrated a similar incidence of net adverse cardiovascular and clinical events at 12 months after second-generation DES in ACS compared with standard duration DAPT (12 months).",
author = "Jang, {Ji Yong} and Shin, {Dong Ho} and Kim, {Jung Sun} and Hong, {Sung Jin} and Ahn, {Chul Min} and Kim, {Byeong Keuk} and Ko, {Young Guk} and Donghoon Choi and Hong, {Myeong Ki} and Park, {Kyung Woo} and Gwon, {Hyeon Cheol} and Kim, {Hyo Soo} and Yangsoo Jang",
year = "2018",
month = "11",
doi = "10.1371/journal.pone.0207386",
language = "English",
volume = "13",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "11",

}

Jang, JY, Shin, DH, Kim, JS, Hong, SJ, Ahn, CM, Kim, BK, Ko, YG, Choi, D, Hong, MK, Park, KW, Gwon, HC, Kim, HS & Jang, Y 2018, 'Optimal duration of DAPT after second-generation drug-eluting stent in acute coronary syndrome', PloS one, vol. 13, no. 11, e0207386. https://doi.org/10.1371/journal.pone.0207386

Optimal duration of DAPT after second-generation drug-eluting stent in acute coronary syndrome. / Jang, Ji Yong; Shin, Dong Ho; Kim, Jung Sun; Hong, Sung Jin; Ahn, Chul Min; Kim, Byeong Keuk; Ko, Young Guk; Choi, Donghoon; Hong, Myeong Ki; Park, Kyung Woo; Gwon, Hyeon Cheol; Kim, Hyo Soo; Jang, Yangsoo.

In: PloS one, Vol. 13, No. 11, e0207386, 11.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Optimal duration of DAPT after second-generation drug-eluting stent in acute coronary syndrome

AU - Jang, Ji Yong

AU - Shin, Dong Ho

AU - Kim, Jung Sun

AU - Hong, Sung Jin

AU - Ahn, Chul Min

AU - Kim, Byeong Keuk

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Hong, Myeong Ki

AU - Park, Kyung Woo

AU - Gwon, Hyeon Cheol

AU - Kim, Hyo Soo

AU - Jang, Yangsoo

PY - 2018/11

Y1 - 2018/11

N2 - Background We evaluated optimal duration of dual antiplatelet therapy (DAPT) after second-generation drug-eluting stent (DES) implantation in acute coronary syndrome (ACS). Material and methods From pooled analysis of three randomized clinical trials (EXCELLENT, IVUS-XPL, RESET), a total of 2,216 patient with ACS undergoing second-generation DES implantation were selected. Each study randomized patients to a short-duration DAPT arm (n = 1119; 6 months) or a standard-duration DAPT arm (n = 1097; 12 months). Two-thirds of patients were male, and their mean age was 63 years. Mean DAPT durations were 164 ±76 and 359 ±68 days, respectively. The primary endpoint was composite of cardiac death, myocardial infarction, stent thrombosis, stroke or major bleeding during the first 12 months after implantation, analyzed according to the intention-to-treat population. Results Demographic characteristics were balanced between groups. Mean DAPT duration was 164 and 359 days, respectively. Primary endpoint occurred in 22 patients with short-DAPT and 21 patients with standard-DAPT (2.0% versus 1.9%; hazard ratio [HR] 1.03; 95% confidence interval [CI] 0.56–1.86; p = 0.94). Landmark analysis after six-months, no significant difference in primary endpoint between short and standard duration DAPT (1.0% versus 0.8%; HR 1.22; 95% CI 0.51–2.95; p = 0.66). Conclusions Short-duration DAPT (6 months) demonstrated a similar incidence of net adverse cardiovascular and clinical events at 12 months after second-generation DES in ACS compared with standard duration DAPT (12 months).

AB - Background We evaluated optimal duration of dual antiplatelet therapy (DAPT) after second-generation drug-eluting stent (DES) implantation in acute coronary syndrome (ACS). Material and methods From pooled analysis of three randomized clinical trials (EXCELLENT, IVUS-XPL, RESET), a total of 2,216 patient with ACS undergoing second-generation DES implantation were selected. Each study randomized patients to a short-duration DAPT arm (n = 1119; 6 months) or a standard-duration DAPT arm (n = 1097; 12 months). Two-thirds of patients were male, and their mean age was 63 years. Mean DAPT durations were 164 ±76 and 359 ±68 days, respectively. The primary endpoint was composite of cardiac death, myocardial infarction, stent thrombosis, stroke or major bleeding during the first 12 months after implantation, analyzed according to the intention-to-treat population. Results Demographic characteristics were balanced between groups. Mean DAPT duration was 164 and 359 days, respectively. Primary endpoint occurred in 22 patients with short-DAPT and 21 patients with standard-DAPT (2.0% versus 1.9%; hazard ratio [HR] 1.03; 95% confidence interval [CI] 0.56–1.86; p = 0.94). Landmark analysis after six-months, no significant difference in primary endpoint between short and standard duration DAPT (1.0% versus 0.8%; HR 1.22; 95% CI 0.51–2.95; p = 0.66). Conclusions Short-duration DAPT (6 months) demonstrated a similar incidence of net adverse cardiovascular and clinical events at 12 months after second-generation DES in ACS compared with standard duration DAPT (12 months).

UR - http://www.scopus.com/inward/record.url?scp=85057176134&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057176134&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0207386

DO - 10.1371/journal.pone.0207386

M3 - Article

C2 - 30475845

AN - SCOPUS:85057176134

VL - 13

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 11

M1 - e0207386

ER -