Clinical outcomes according to lesion complexity in high bleeding risk patients treated with 1-month dual antiplatelet therapy following PCI: Analysis from the Onyx ONE clear study.

Kandzari, David E; Kirtane, Ajay J; Mehran, Roxana; Price, Matthew J; Simon, Daniel I; Latib, Azeem; Kedhi, Elvin; Abizaid, Alexandre; Worthley, Stephen G; Zaman, Azfar; Hudec, Martin; Stoler, Robert; Choi, James W; Kanitkar, Mihir; Conradie, Andre; Tam, Chor-Cheung Frankie; Walton, Antony; Gruberg, Luis; Ando, Kenji; Lee, Lilian C; ... (2022). Clinical outcomes according to lesion complexity in high bleeding risk patients treated with 1-month dual antiplatelet therapy following PCI: Analysis from the Onyx ONE clear study. Catheterization and cardiovascular interventions, 99(3), pp. 583-592. Wiley-Blackwell 10.1002/ccd.29939

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OBJECTIVES

To compare clinical outcomes in high bleeding risk (HBR) patients with and without complex percutaneous coronary intervention (PCI) treated with Resolute Onyx zotarolimus-eluting stents (ZES) after 1-month dual antiplatelet therapy (DAPT).

BACKGROUND

PCI with 1-month DAPT has been demonstrated to be safe in HBR patients treated with Resolute Onyx ZES. Whether these outcomes are consistent in patients with complex lesions is uncertain.

METHODS

Among HBR patients who were event-free 1 month after PCI with ZES and treated thereafter with single antiplatelet therapy (SAPT), the clinical outcomes between 1 month and 1 year were compared after complex PCI (3 vessels treated, ≥ 3 lesions treated, total stent length > 60 mm, bifurcation with ≥ 2 stents implanted, atherectomy, or left main, surgical bypass graft or chronic total occlusion PCI) versus noncomplex PCI. Propensity score adjustment was performed to adjust for baseline differences among complex and noncomplex patients.

RESULTS

Complex patients (N = 401, 26.6% of total) had a higher prevalence of hyperlipidemia, diabetes mellitus and previous myocardial infarction (MI). Between 1 month and 1 year, rates of MI (7.1% vs. 4.0%, p = 0.02) and cardiac death/MI (9.3% vs. 6.1%, p = 0.04) were higher among complex versus noncomplex patients, although stent thrombosis rates were similar. After adjustment for baseline characteristics, differences in outcomes were no longer significant between groups.

CONCLUSIONS

Higher rates of ischemic outcomes in complex PCI patients were largely explained by baseline clinical differences, rather than lesion complexity, among HBR patients treated with 1-month DAPT following PCI with Resolute Onyx ZES.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1522-1946

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

20 Jan 2022 09:24

Last Modified:

05 Dec 2022 15:59

Publisher DOI:

10.1002/ccd.29939

PubMed ID:

34478233

Uncontrolled Keywords:

antiplatelet therapy complex percutaneous coronary intervention coronary artery disease drug-eluting stents

BORIS DOI:

10.48350/163189

URI:

https://boris.unibe.ch/id/eprint/163189

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