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首页> 外文期刊>Circulation journal >Optimal Duration for Dual Antiplatelet Therapy After Left Main Coronary Artery Stenting
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Optimal Duration for Dual Antiplatelet Therapy After Left Main Coronary Artery Stenting

机译：左主冠状动脉支架后双抗血小板治疗的最佳持续时间

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Background: Coronary interventions using drug-eluting stents (DESs) of left main coronary artery (LMCA) lesions have shown favorable clinical outcomes. However, duration of dual antiplatelet therapy (DAPT) after LMCA interventions has not yet been investigated. Methods?and?Results: From a multicenter Korean Multicenter Angioplasty Team (KOMATE) registry, 1,004 patients who received DES implantations for LMCA lesions and did not experience major adverse cardiovascular events (including major bleeding) for 1 year after coronary intervention were analyzed. Patients were divided into 2 groups; DAPT ≤12 (n=503) and 12 months (n=501). The primary endpoint was number of net clinical adverse events (NACEs), composite of cardiac deaths, myocardial infarctions, stent thrombosis and major bleeding events. During a 4.5-year follow-up period after LMCA interventions, the DAPT 12 months group showed a lower NACE rate than the DAPT ≤12 months group (adjusted-HR 0.53 [0.29–0.99], P=0.045). For patients who maintained DAPT 12 months, rate of cardiac deaths, myocardial infarctions, and stent thrombosis events were lower than in patients who had DAPT ≤12 months (adjusted-HR 0.35 [0.17–0.73], P=0.005) without increased major bleeding (P=0.402). Conclusions: For patients who can continue DAPT without major bleeding events, prolonged DAPT (12 months) after LMCA stenting demonstrated better long-term efficacy outcomes than DAPT ≤12 months with comparable safety.
机译：背景技术：使用左主冠状动脉（LMCA）病变的药物洗脱支架（DESS）的冠状动脉干预表现出良好的临床结果。然而，尚未调查LMCA干预后的双抗血小板治疗（DAPT）的持续时间。方法？结果：来自多中心韩国多中心血管成形术队（Komate）注册表，1,004名接受LMCA病变的DES植入患者，并在分析冠状动脉干预后1年内没有经历主要的不良心血管事件（包括重大出血）。患者分为2组; DAPT≤12（n = 503）和> 12个月（n = 501）。主要终点是净临床不良事件（NACE）的数量，心脏死亡，心肌梗死，支架血栓形成和主要出血事件的综合。在LMCA干预后4.5年的随访期间，DAPT> 12个月组的NACE率比DAPT≤12个月组（调节-HR 0.53 [0.29-0.99]，P = 0.045）。对于维持DAPT> 12个月的患者，心脏死亡率，心肌梗死和支架血栓形成事件的速率低于DAPT≤12个月的患者（调整-HR 0.35 [0.17-0.73]，P = 0.005）而没有增加出血（p = 0.402）。结论：对于在没有重大出血事件的情况下，对于可以继续进行DAPT的患者，LMCA支架后的延长DAPT（> 12个月）展示了比DAPT≤12个月的更好的长期疗效结果，具有可比的安全性。

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