김중선 (연세대학교 의과대학, 세브란스병원) | 한빛사논문 > 한빛사

한빛사논문

조회638

연세대학교 의과대학, 세브란스병원

CV File 394 kb

JACC-Cardiovasc. Interv., Available online 28 July 2021 | https://doi.org/10.1016/j.jcin.2021.06.003 1-Month Dual-Antiplatelet Therapy Followed by Aspirin Monotherapy After Polymer-Free Drug-Coated Stent Implantation: 1-Month DAPT Trial

Sung-Jin Hong MD^a,∗, Jung-Sun Kim MD^a,∗, Soon Jun Hong MD^b, Do-Sun Lim MD^b, Seung-Yul Lee MD^c, Kyeong Ho Yun MD^c, Jong-Kwan Park MD^d, Woong Chol Kang MD^e, Yong Hoon Kim MD^f, Hyuck-Jun Yoon MD^g, Hoyoun Won MD^h, Chung-Mo Nam PhDⁱ, Chul-Min Ahn MD^a, Byeong-Keuk Kim MD^a, Young-Guk Ko MD^a, Donghoon Choi MD^a, Yangsoo Jang MD^a, Myeong-Ki Hong MD^a,# for the One-Month DAPT Investigators

^aSeverance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
^bKorea University College of Medicine, Seoul, Korea
^cWonkwang University Hospital, Iksan, Korea
^dNational Health Insurance Service Ilsan Hospital, Goyang, Korea
^eGachon University College of Medicine, Incheon, Korea
^fKangwon National University School of Medicine, Chuncheon, Korea
^gKeimyung University College of Medicine, Daegu, Korea
^hChung-Ang University College of Medicine, Seoul, Korea
ⁱDepartment of Preventive Medicine and Biostatistics, Yonsei University College of Medicine, Seoul, Korea

^∗Drs. Sung-Jin Hong and Jung-Sun Kim contributed equally to this work.

^#Corresponding author.

Abstract

Objectives
The aim of this study was to determine whether 1 month of dual-antiplatelet therapy (DAPT) followed by aspirin monotherapy after polymer-free drug-coated stent (PF-DCS) implantation is noninferior to 6 to 12 months of DAPT after biodegradable-polymer drug-eluting stent (BP-DES) implantation.

Background
It is necessary to determine the optimal minimal duration of DAPT followed by aspirin monotherapy after percutaneous coronary intervention (PCI).

Methods
In this trial, 3,020 patients with coronary artery disease considered for PCI for noncomplex lesions were randomized to 1-month DAPT after PF-DCS (n = 1,507) or 6- to 12-month DAPT after BP-DES (n = 1,513). The primary endpoint was the 1-year composite of cardiac death, nonfatal myocardial infarction, target vessel revascularization, stroke, or major bleeding (noninferiority hypothesis margin of 3%).

Results
The primary endpoint occurred in 88 patients (5.9%) in the 1-month DAPT after PF-DCS group and 98 patients (6.5%) in the 6- to 12-month DAPT after BP-DES group (absolute difference −0.7%; upper limit of 1-sided 97.5% confidence interval: 1.33%; P < 0.001 for noninferiority). The occurrence of major bleeding was not different (1.7% vs 2.5%; P = 0.136). There was no difference in the occurrence of stent thrombosis (0.7% vs 0.8%; P = 0.842).

Conclusions
Among patients who underwent PCI for noncomplex lesions, 1-month DAPT followed by aspirin monotherapy after PF-DCS implantation was noninferior to 6- to 12-month DAPT after BP-DES implantation for the 1-year composite of cardiovascular events or major bleeding. The present findings need to be interpreted in the setting of different types of stents according to antiplatelet strategy. (A Randomized Controlled Comparison Between One Versus More Than Six Months of Dual Antiplatelet Therapy After Biolimus A9-Eluting Stent Implantation; NCT02513810)

논문정보

형식Research article
게재일2021년 07월 (BRIC 등록일 2021-08-12)
연구진국내 연구진
분야 의약학 > 응용의학

댓글 작성 로그인

CV 열람하기

연락처 보기