Single antiplatelet therapy with use of prasugrel in patients undergoing percutaneous coronary intervention.

Otsuka, Tatsuhiko; Ueki, Yasushi; Kavaliauskaite, Raminta; Zanchin, Thomas; Bär, Sarah; Stortecky, Stefan; Pilgrim, Thomas; Valgimigli, Marco; Meier, Bernhard; Heg, Dik; Windecker, Stephan; Räber, Lorenz (2021). Single antiplatelet therapy with use of prasugrel in patients undergoing percutaneous coronary intervention. (In Press). Catheterization and cardiovascular interventions Wiley-Blackwell 10.1002/ccd.29650

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OBJECTIVES

We aimed to assess the ischemic and bleeding risks of single antiplatelet therapy (SAPT) with prasugrel compared with standard dual antiplatelet therapy (DAPT) (aspirin plus clopidogrel for 1 year) in patients with chronic coronary syndrome (CCS) treated with new generation drug-eluting stents (DES).

BACKGROUND

To date, data on SAPT with potent P2Y12 inhibitors in the absence of aspirin immediately after PCI are limited.

METHODS

Between January 2009 and November 2019, all CCS patients undergoing percutaneous coronary intervention (PCI) enrolled to the Bern PCI registry were considered for analysis. We performed propensity score matching in a 1:4 fashion to compare patients who received SAPT with prasugrel versus standard DAPT. The primary ischemic endpoint was a composite of cardiovascular death, myocardial infarction, and stroke and the primary bleeding endpoint was BARC 3 or 5 bleeding, both assessed at 1 year.

RESULTS

After propensity score matching, the final study population consisted of 225 patients with SAPT and 889 with DAPT. There was no significant difference in rates of the primary ischemic (5.2% vs. 4.2%, p = .50) or the primary bleeding (1.5% vs. 2.0%, p = .60) endpoints between groups. SAPT was not associated with an increased risk of definite stent thrombosis (0.9% vs. 0.8%, p = .83).

CONCLUSIONS

Among selected CCS patients undergoing PCI with DES, SAPT with prasugrel was not associated with an excess of ischemic events compared with standard DAPT. No difference in bleeding was observed either. The results may serve as the basis for larger trials assessing the potential benefits and risks of SAPT.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Otsuka, Tatsuhiko; Ueki, Yasushi; Kavaliauskaite, Raminta; Zanchin, Thomas; Bär, Sarah; Stortecky, Stefan; Pilgrim, Thomas; Valgimigli, Marco; Meier, Bernhard; Heg, Dierik Hans; Windecker, Stephan and Räber, Lorenz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1522-1946

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

30 Mar 2021 19:11

Last Modified:

30 Mar 2021 19:11

Publisher DOI:

10.1002/ccd.29650

PubMed ID:

33754441

Uncontrolled Keywords:

antiplatelet therapy bleeding coronary artery disease percutaneous coronary intervention

BORIS DOI:

10.48350/155057

URI:

https://boris.unibe.ch/id/eprint/155057

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