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.
|Translated title of the contribution||Dual antiplatelet therapy after percutaneous coronary intervention for left main coronary artery disease|
|Journal||Revista Espanola de Cardiologia|
|Publication status||Accepted/In press - 2022|
Bibliographical noteFunding Information:
Este trabajo contó con el apoyo de la CardioVascular Research Foundation, Seúl, República de Corea (2015-09) y del Korea Health Technology R&D Project a través del Korea Health Industry Development Institute (KHIDI), financiado por el Ministerio de Salud y Bienestar (HI20C1566), el Ministerio de Ciencia y TIC (2017M3A9E9073585) y el Cardiovascular Research Center (Seúl, República de Corea).
© 2022 Sociedad Española de Cardiología
All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine