Costa, Francesco; Adamo, Marianna; Ariotti, Sara; Ferrante, Giuseppe; Navarese, Eliano Pio; Leonardi, Sergio; Garcia-Garcia, Hector; Vranckx, Pascal; Valgimigli, Marco (2016). Left main or proximal left anterior descending coronary artery disease location identifies high-risk patients deriving potentially greater benefit from prolonged dual antiplatelet therapy duration. EuroIntervention, 11(11), e1222-e1230. Europa Digital & Publishing 10.4244/EIJY15M08_04
Full text not available from this repository. (Request a copy)AIMS
It is currently unclear if the location of coronary artery disease affects decision making with regard to dual antiplatelet therapy (DAPT). We investigated if the presence of at least 30% luminal narrowing in the left main (LM) and/or proximal left anterior descending (pLAD) coronary arteries on angiography is an outcome modifier with respect to DAPT duration.
METHODS AND RESULTS
In the Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia (PRODIGY) study, 953 (54.3%) patients with and 801 (45.7%) without LM/pLAD lumen narrowing at the qualifying coronary intervention were randomised to six or 24 months of DAPT. Twenty-four month as compared to six-month DAPT reduced the occurrence of definite, probable or possible stent thrombosis by 50% in patients with (2.8% vs. 5.6%; HR 0.45, 95% CI: 0.23-0.89; p=0.02) but not in those without LM/pLAD lumen narrowing, with a highly significant interaction testing (PINT= 0.002). This result remained consistent irrespective of whether stenting was (PINT: 0.01) or was not (PINT: 0.02) performed in the LM/pLAD.
CONCLUSIONS
Left main and/or proximal LAD lumen narrowing may be a treatment modifier with respect to the duration of DAPT. Patients fulfilling these angiographic characteristics seem to benefit from a prolonged dual antiplatelet treatment. Trial registration: ClinicalTrials.gov Identifier: NCT00611286
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Ariotti, Sara, Valgimigli, Marco |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1774-024X |
Publisher: |
Europa Digital & Publishing |
Language: |
English |
Submitter: |
Daria Vogelsang |
Date Deposited: |
12 Apr 2017 12:47 |
Last Modified: |
05 Dec 2022 15:01 |
Publisher DOI: |
10.4244/EIJY15M08_04 |
PubMed ID: |
26342472 |
URI: |
https://boris.unibe.ch/id/eprint/92888 |
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