Dual antiplatelet therapy beyond 12 months versus for 12 months after drug-eluting stents for acute myocardial infarction

KAMIR-NIH registry investigators

Research output: Contribution to journalArticle

Abstract

Background: The optimal duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome remains uncertain. This study investigated the benefit of DAPT beyond 12 months after drug-eluting stents (DES) for acute myocardial infarction (MI). Methods: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 6199 patients treated with DAPT for 12 months after DES (second-generation DES 98%) without ischemic or bleeding events were analyzed. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of death from any cause, MI, or ischemic stroke during the period from 12 to 24 months. Results: After adjustment using inverse probability of treatment weighting, patients who received DAPT beyond 12 months (n = 4795), compared to patients treated with 12-month DAPT (n = 1404), had a similar incidence of MACCE (1.3% vs. 1.0%, HR: 1.32, 95% CI: 0.71–2.45, p = 0.378). The 2 groups did not differ significantly in the rates of death (0.1% vs. 0.1%), MI (0.8% vs.0.6%), stent thrombosis (0.1% vs. 0.2%), ischemic stroke (0.4% vs. 0.2%), and major bleeding (0.1% vs. 0.1%). The rate of net adverse clinical events was 1.4% with DAPT beyond 12 months and 1.1% with 12-month DAPT (p = 0.466). Conclusions: DAPT beyond 12 months, as compared with 12-month DAPT, in real-world patients with acute MI treated predominantly with second-generation DES did not reduce the risk of MACCE. The rates of major bleeding and net adverse clinical events did not differ significantly between the 2 treatments.

Original languageEnglish
Pages (from-to)66-73
Number of pages8
JournalJournal of Cardiology
Volume75
Issue number1
DOIs
StatePublished - Jan 2020

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Drug-Eluting Stents
Myocardial Infarction
Therapeutics
Hemorrhage
Stroke
National Institutes of Health (U.S.)
Acute Coronary Syndrome
Korea
Stents
Registries
Cause of Death
Thrombosis
Databases

Keywords

  • Antiplatelet agents
  • Drug-eluting stents
  • Myocardial infarction

Cite this

@article{1b457691f56c47afad579d5d5e8de8e4,
title = "Dual antiplatelet therapy beyond 12 months versus for 12 months after drug-eluting stents for acute myocardial infarction",
abstract = "Background: The optimal duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome remains uncertain. This study investigated the benefit of DAPT beyond 12 months after drug-eluting stents (DES) for acute myocardial infarction (MI). Methods: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 6199 patients treated with DAPT for 12 months after DES (second-generation DES 98{\%}) without ischemic or bleeding events were analyzed. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of death from any cause, MI, or ischemic stroke during the period from 12 to 24 months. Results: After adjustment using inverse probability of treatment weighting, patients who received DAPT beyond 12 months (n = 4795), compared to patients treated with 12-month DAPT (n = 1404), had a similar incidence of MACCE (1.3{\%} vs. 1.0{\%}, HR: 1.32, 95{\%} CI: 0.71–2.45, p = 0.378). The 2 groups did not differ significantly in the rates of death (0.1{\%} vs. 0.1{\%}), MI (0.8{\%} vs.0.6{\%}), stent thrombosis (0.1{\%} vs. 0.2{\%}), ischemic stroke (0.4{\%} vs. 0.2{\%}), and major bleeding (0.1{\%} vs. 0.1{\%}). The rate of net adverse clinical events was 1.4{\%} with DAPT beyond 12 months and 1.1{\%} with 12-month DAPT (p = 0.466). Conclusions: DAPT beyond 12 months, as compared with 12-month DAPT, in real-world patients with acute MI treated predominantly with second-generation DES did not reduce the risk of MACCE. The rates of major bleeding and net adverse clinical events did not differ significantly between the 2 treatments.",
keywords = "Antiplatelet agents, Drug-eluting stents, Myocardial infarction",
author = "{KAMIR-NIH registry investigators} and Sim, {Doo Sun} and Jeong, {Myung Ho} and Kim, {Hyo Soo} and Gwon, {Hyeon Cheol} and Seung, {Ki Bae} and Rha, {Seung Woon} and Chae, {Shung Chull} and Kim, {Chong Jin} and Cha, {Kwang Soo} and Park, {Jong Seon} and Yoon, {Jung Han} and Chae, {Jei Keon} and Joo, {Seung Jae} and Choi, {Dong Ju} and Hur, {Seung Ho} and Seong, {In Whan} and Cho, {Myeong Chan} and Kim, {Doo Il} and Oh, {Seok Kyu} and Ahn, {Tae Hoon} and Hwang, {Jin Yong}",
year = "2020",
month = "1",
doi = "10.1016/j.jjcc.2019.06.006",
language = "English",
volume = "75",
pages = "66--73",
journal = "Journal of Cardiology",
issn = "0914-5087",
publisher = "Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)",
number = "1",

}

Dual antiplatelet therapy beyond 12 months versus for 12 months after drug-eluting stents for acute myocardial infarction. / KAMIR-NIH registry investigators.

In: Journal of Cardiology, Vol. 75, No. 1, 01.2020, p. 66-73.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dual antiplatelet therapy beyond 12 months versus for 12 months after drug-eluting stents for acute myocardial infarction

AU - KAMIR-NIH registry investigators

AU - Sim, Doo Sun

AU - Jeong, Myung Ho

AU - Kim, Hyo Soo

AU - Gwon, Hyeon Cheol

AU - Seung, Ki Bae

AU - Rha, Seung Woon

AU - Chae, Shung Chull

AU - Kim, Chong Jin

AU - Cha, Kwang Soo

AU - Park, Jong Seon

AU - Yoon, Jung Han

AU - Chae, Jei Keon

AU - Joo, Seung Jae

AU - Choi, Dong Ju

AU - Hur, Seung Ho

AU - Seong, In Whan

AU - Cho, Myeong Chan

AU - Kim, Doo Il

AU - Oh, Seok Kyu

AU - Ahn, Tae Hoon

AU - Hwang, Jin Yong

PY - 2020/1

Y1 - 2020/1

N2 - Background: The optimal duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome remains uncertain. This study investigated the benefit of DAPT beyond 12 months after drug-eluting stents (DES) for acute myocardial infarction (MI). Methods: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 6199 patients treated with DAPT for 12 months after DES (second-generation DES 98%) without ischemic or bleeding events were analyzed. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of death from any cause, MI, or ischemic stroke during the period from 12 to 24 months. Results: After adjustment using inverse probability of treatment weighting, patients who received DAPT beyond 12 months (n = 4795), compared to patients treated with 12-month DAPT (n = 1404), had a similar incidence of MACCE (1.3% vs. 1.0%, HR: 1.32, 95% CI: 0.71–2.45, p = 0.378). The 2 groups did not differ significantly in the rates of death (0.1% vs. 0.1%), MI (0.8% vs.0.6%), stent thrombosis (0.1% vs. 0.2%), ischemic stroke (0.4% vs. 0.2%), and major bleeding (0.1% vs. 0.1%). The rate of net adverse clinical events was 1.4% with DAPT beyond 12 months and 1.1% with 12-month DAPT (p = 0.466). Conclusions: DAPT beyond 12 months, as compared with 12-month DAPT, in real-world patients with acute MI treated predominantly with second-generation DES did not reduce the risk of MACCE. The rates of major bleeding and net adverse clinical events did not differ significantly between the 2 treatments.

AB - Background: The optimal duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome remains uncertain. This study investigated the benefit of DAPT beyond 12 months after drug-eluting stents (DES) for acute myocardial infarction (MI). Methods: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 6199 patients treated with DAPT for 12 months after DES (second-generation DES 98%) without ischemic or bleeding events were analyzed. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of death from any cause, MI, or ischemic stroke during the period from 12 to 24 months. Results: After adjustment using inverse probability of treatment weighting, patients who received DAPT beyond 12 months (n = 4795), compared to patients treated with 12-month DAPT (n = 1404), had a similar incidence of MACCE (1.3% vs. 1.0%, HR: 1.32, 95% CI: 0.71–2.45, p = 0.378). The 2 groups did not differ significantly in the rates of death (0.1% vs. 0.1%), MI (0.8% vs.0.6%), stent thrombosis (0.1% vs. 0.2%), ischemic stroke (0.4% vs. 0.2%), and major bleeding (0.1% vs. 0.1%). The rate of net adverse clinical events was 1.4% with DAPT beyond 12 months and 1.1% with 12-month DAPT (p = 0.466). Conclusions: DAPT beyond 12 months, as compared with 12-month DAPT, in real-world patients with acute MI treated predominantly with second-generation DES did not reduce the risk of MACCE. The rates of major bleeding and net adverse clinical events did not differ significantly between the 2 treatments.

KW - Antiplatelet agents

KW - Drug-eluting stents

KW - Myocardial infarction

UR - http://www.scopus.com/inward/record.url?scp=85072586455&partnerID=8YFLogxK

U2 - 10.1016/j.jjcc.2019.06.006

DO - 10.1016/j.jjcc.2019.06.006

M3 - Article

C2 - 31561932

AN - SCOPUS:85072586455

VL - 75

SP - 66

EP - 73

JO - Journal of Cardiology

JF - Journal of Cardiology

SN - 0914-5087

IS - 1

ER -