Background: Studies have suggested that use of prolonged dual antiplatelet therapy (DAPT) following new generation drug-eluting stent implantation may increase costs and potential bleeding events. This study aimed to investigate the association of DAPT status with clinical safety in patients undergoing everolimus-eluting stent (EES) implantation in the SEEDS study (A Registry to Evaluate Safety and Effectiveness of Everolimus Drug-eluting Stent for Coronary Revascularization) at 2-year follow-up. Methods: The SEEDS study is a prospective, multicenter study, where patients (n = 1900) with small vessel, long lesion, or multi-vessel diseases underwent EES implantation. Detailed DAPT status was collected at baseline, 6-month, 1- and 2-year. DAPT interruption was defined as any interruption of aspirin and/or clopidogrel more than 14 days. The net adverse clinical events (NACE, a composite endpoint of all-cause death, all myocardial infarction (MI), stroke, definite/probable stent thrombosis (ST), and major bleeding (Bleeding Academic Research Consortium II-V)) were investigated according to the DAPT status at 2-year follow-up. Results: DAPT was used in 97.8% of patients at 6 months, 69.5% at 12 months and 35.4% at 2 years. It was observed that the incidence of NACE was low (8.1%) at 2 years follow-up, especially its components of all-cause death (0.9%), stroke (1.1%), and definite/probable ST (0.7%). DAPT was not an independent predictor of composite endpoint of all-cause death/MI/stroke (hazard ratio [HR]: 0.693, 95% confidence interval [CI]: 0.096-4.980, P = 0.715) and NACE (HR: 1.041, 95% CI: 0.145-7.454, P = 0.968). Of 73 patients who had DAPT interruption, no patient had ST at 12-month, and only 1 patient experienced ST between 1- and 2-year (1.4%). There was a high frequency of major bleeding events (53/65, 82.5%) occurred in patients receiving DAPT treatment. Conclusions: Prolonged DAPT use was not associated with improved clinical safety. The study emphasized that duration of DAPT needs to be shortened in Chinese patients following EES implantation (ClinicalTrials. gov identifier: NCT 01157455).
基金：
Abbott Vascular, Santa Clara, CA, USAAbbott Laboratories
语种：
外文
被引次数：
WOS：
中科院(CAS)分区：
出版当年[2014]版：
大类|4 区医学
小类|4 区医学：内科
最新[2023]版：
大类|3 区医学
小类|3 区医学：内科
第一作者：
第一作者机构：[1]Nanjing Med Univ, Nanjing Hosp 1, Dept Cardiol, Nanjing 210006, Jiangsu, Peoples R China;
通讯作者：
通讯机构：[2]Fuwai Hosp, Natl Ctr Cardiovasc Dis, Dept Cardiol, Beijing 100037, Peoples R China;[9]Fuwai Hosp, Natl Ctr Cardiovasc Dis, Dept Cardiol, A167 Beilishi Rd, Beijing 100037, Peoples R China
推荐引用方式(GB/T 7714)：
Zhang Yao-Jun,Zhao Ye-Lin,Xu Bo,et al.Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation: Insights from the SEEDS Study[J].CHINESE MEDICAL JOURNAL.2015,128(6):714-720.doi:10.4103/0366-6999.152458.
APA：
Zhang, Yao-Jun,Zhao, Ye-Lin,Xu, Bo,Han, Ya-Ling,Li, Bao...&Yang, Yue-Jin.(2015).Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation: Insights from the SEEDS Study.CHINESE MEDICAL JOURNAL,128,(6)
MLA：
Zhang, Yao-Jun,et al."Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation: Insights from the SEEDS Study".CHINESE MEDICAL JOURNAL 128..6(2015):714-720
