Abbreviated Versus Standard Dual Antiplatelet Therapy Times After Percutaneous Coronary Intervention in Patients With High Bleeding Risk With Acute Coronary Syndrome: Insights From the SWEDEHEART Registry.

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Abbreviated Versus Standard Dual Antiplatelet Therapy Times After Percutaneous Coronary Intervention in Patients With High Bleeding Risk With Acute Coronary Syndrome: Insights From the SWEDEHEART Registry.

Håkansson, Anton (författare): Department of Cardiology, Clinical Sciences Lund University, Skåne University Hospital Lund Sweden, Sweden,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, S-22185 Lund, Sweden.

Koul, Sasha (författare): Department of Cardiology, Clinical Sciences Lund University, Skåne University Hospital Lund Sweden, Sweden,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, S-22185 Lund, Sweden.

Omerovic, Elmir, 1968 (författare): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Cardiology Sahlgrenska University Hospital, Gothenburg University Gothenburg Sweden, Sweden,Gothenburg Univ, Sahlgrenska Univ Hosp, Dept Cardiol, Gothenburg, Sweden.

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Andersson, Jonas (författare): Umeå universitet,Kardiologi,Umeå Univ, Dept Cardiol, Umeå, Sweden.

James, Stefan, 1964- (författare): Uppsala universitet,Kardiologi

Agewall, Stefan (författare): Department of Clinical sciences, Danderyd Hospital Karolinska institutet Stockholm Sweden, Sweden,Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden.

Mokhtari, Arash (författare): Department of Cardiology, Clinical Sciences Lund University, Skåne University Hospital Lund Sweden, Sweden,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, S-22185 Lund, Sweden.

van Der Pals, Jesper (författare): Department of Cardiology, Clinical Sciences Lund University, Skåne University Hospital Lund Sweden, Sweden,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, S-22185 Lund, Sweden.

Wester, Axel (författare): Department of Medicine Huddinge, Karolinska Institutet Stockholm Sweden, Sweden,Karolinska Inst, Dept Med, Stockholm, Sweden.

Szummer, Karolina (författare): Department of Clinical sciences, Danderyd Hospital Karolinska institutet Stockholm Sweden, Sweden,Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden.

Jernberg, Tomas (författare): Karolinska Institutet

Erlinge, David (författare): Department of Cardiology, Clinical Sciences Lund University, Skåne University Hospital Lund Sweden, Sweden,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, S-22185 Lund, Sweden.

Mohammad, Moman A (författare): Department of Cardiology, Clinical Sciences Lund University, Skåne University Hospital Lund Sweden, Sweden,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, S-22185 Lund, Sweden.

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Department of Cardiology, Clinical Sciences Lund University, Skåne University Hospital Lund Sweden, Sweden Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, S-22185 Lund, Sweden (creator_code:org_t)

The American Heart Association, 2024
2024
Engelska.
Ingår i: Journal of the American Heart Association. - : The American Heart Association. - 2047-9980. ; 13:13

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Dual antiplatelet therapy (DAPT) reduces ischemic events but increases bleeding risk, especially in patients with high bleeding risk (HBR). This study aimed to compare outcomes of abbreviated versus standard DAPT strategies in patients with HBR with acute coronary syndrome undergoing percutaneous coronary intervention.Patients from the SWEDEHEART (Swedish Web-system for Enhancement and Development of Evidence-Based Bare in Heart Disease Evaluated According to Recommended Therapies) registry with at least 1 HBR criterion who underwent percutaneous coronary intervention for acute coronary syndrome were identified and included. Patients were divided into 2 groups based on their planned DAPT time at discharge: 12-month DAPT or an abbreviated DAPT strategy and matched according to their prescribed P2Y12 inhibitor at discharge. The primary outcome assessed was time to net adverse clinical events at 1year, which encompassed cardiac death, myocardial infarction, ischemic stroke, or clinically significant bleeding. Time to major adverse cardiovascular events and the individual components of net adverse clinical events were considered secondary end points. A total of 4583 patients were included in each group. The most frequently met HBR criteria was age older than 75years (65.6%) and Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy score ≥25 (44.6%) in the standard DAPT group and oral anticoagulant therapy (79.6%) and age 75years and older (55.2%) in the abbreviated DAPT group. There was no statistically significant difference in net adverse clinical events (12.9% versus 13.1%; hazard ratio [HR], 0.99 [95% CI, 0.88-1.11], P=0.83), major adverse cardiovascular events (8.6% versus 7.9%; HR, 1.08 [95% CI, 0.94-1.25]), or their components between groups. The results were consistent among all of the investigated subgroups.In patients with HBR undergoing percutaneous coronary intervention due to acute coronary syndrome, abbreviated DAPT was associated with comparable rates of net adverse clinical events and major adverse cardiovascular events to a DAPT duration of 12months.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Humans
Acute Coronary Syndrome
therapy
mortality
complications
Percutaneous Coronary Intervention
adverse effects
Male
Female
Aged
Registries
Dual Anti-Platelet Therapy
adverse effects
methods
Hemorrhage
chemically induced
epidemiology
Platelet Aggregation Inhibitors
adverse effects
administration & dosage
Middle Aged
Time Factors
Sweden
epidemiology
Risk Factors
Risk Assessment
Treatment Outcome
Drug Administration Schedule
Aged
80 and over
Purinergic P2Y Receptor Antagonists
adverse effects
administration & dosage
therapeutic use
acute coronary syndrome

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Av författaren/redakt...: Håkansson, Anton; Koul, Sasha; Omerovic, Elmir, ...; Andersson, Jonas; James, Stefan, 1 ...; Agewall, Stefan; visa fler...; Mokhtari, Arash; van Der Pals, Je ...; Wester, Axel; Szummer, Karolin ...; Jernberg, Tomas; Erlinge, David; Mohammad, Moman ...; visa färre...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

Artiklar i publikationen: Journal of the A ...

Av lärosätet: Göteborgs universitet; Umeå universitet; Uppsala universitet; Karolinska Institutet

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