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Review

Optimal duration of dual antiplatelet therapy after PCI: integrating procedural complexity, bleeding risk and the acuteness of clinical presentation

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Pages 735-748 | Received 19 Apr 2018, Accepted 11 Sep 2018, Published online: 04 Oct 2018

References

  • Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. Eur J Cardiothorac Surg. 2018;53:34–78.
  • Levine GN, Bates ER, Bittl JA, et al. 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2016;68:1082–1115.
  • Mehran R, Giustino G, Baber U. DAPT duration after DES: what is the “mandatory” duration? J Am Coll Cardiol. 2015;65:1103–1106.
  • Habib A, Finn AV. Endothelialization of drug eluting stents and its impact on dual anti-platelet therapy duration. Pharmacol Res. 2015;93:22–27.
  • Genereux P, Giustino G, Witzenbichler B, et al. Incidence, predictors, and impact of post-discharge bleeding after percutaneous coronary intervention. J Am Coll Cardiol. 2015;66:1036–1045.
  • Baber U, Mehran R, Giustino G, et al. Coronary thrombosis and major bleeding after PCI with drug-eluting stents: risk scores from PARIS. J Am Coll Cardiol. 2016;67:2224–2234.
  • Secemsky EA, Yeh RW, Kereiakes DJ, et al. Mortality following cardiovascular and bleeding events occurring beyond 1 Year after coronary stenting: a secondary analysis of the dual antiplatelet therapy (DAPT) study. JAMA Cardiol. 2017;2:478–487.
  • Schomig A, Neumann FJ, Kastrati A, et al. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med. 1996;334:1084–1089.
  • Leon MB, Baim DS, Popma JJ, et al. A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stentingr stent anticoagulation restenosis study investigators. N Engl J Med. 1998;339:1665–1671.
  • Stone GW, Ellis SG, Cox DA, et al. A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med. 2004;350:221–231.
  • Morice MC, Serruys PW, Sousa JE, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002;346:1773–1780.
  • Airoldi F, Colombo A, Morici N, et al. Incidence and predictors of drug-eluting stent thrombosis during and after discontinuation of thienopyridine treatment. Circulation. 2007;116:745–754.
  • Iakovou I, Schmidt T, Bonizzoni E, et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. Jama. 2005;293:2126–2130.
  • van Werkum JW, Heestermans AA, Zomer AC, et al. Predictors of coronary stent thrombosis: the Dutch stent thrombosis registry. J Am Coll Cardiol. 2009;53:1399–1409.
  • Camenzind E, Boersma E, Wijns W, et al. Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type. Eur Heart J. 2014;35:1932–1948.
  • Holmes DR Jr., Kereiakes DJ, Garg S, et al. Stent thrombosis. J Am Coll Cardiol. 2010;56:1357–1365.
  • Joner M, Finn AV, Farb A, et al. Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol. 2006;48:193–202.
  • Giustino G, Harari R, Baber U, et al. Long-term safety and efficacy of new-generation drug-eluting stents in women with acute myocardial infarction: from the Women in Innovation and Drug-Eluting Stents (WIN-DES) collaboration. JAMA Cardiol. 2017;2:855–862.
  • Yu J, Baber U, Mastoris I, et al. Sex-based differences in cessation of dual-antiplatelet therapy following percutaneous coronary intervention with stents. JACC Cardiovasc Interv. 2016;9:1461–1469.
  • Dangas GD, Giustino G. Can coronary stent implantation complexity become an intuitive and useful factor to tailor DAPT duration? JACC Cardiovasc Interv. 2016;9:1447–1449.
  • Giustino G, Baber U, Stefanini GG, et al. Impact of clinical presentation (stable angina pectoris vs unstable angina pectoris or non-ST-elevation myocardial infarction vs ST-elevation myocardial infarction) on long-term outcomes in women undergoing percutaneous coronary intervention with drug-eluting stents. Am J Cardiol. 2015;116:845–852.
  • Serruys PW, Silber S, Garg S, et al. Comparison of zotarolimus-eluting and everolimus-eluting coronary stents. N Engl J Med. 2010;363:136–146.
  • Stone GW, Rizvi A, Newman W, et al. Everolimus-eluting versus paclitaxel-eluting stents in coronary artery disease. N Engl J Med. 2010;362:1663–1674.
  • Windecker S, Serruys PW, Wandel S, et al. Biolimus-eluting stent with biodegradable polymer versus sirolimus-eluting stent with durable polymer for coronary revascularisation (LEADERS): a randomised non-inferiority trial. Lancet. 2008;372:1163–1173.
  • Giustino G, Baber U, Aquino M, et al. Safety and efficacy of new-generation drug-eluting stents in women undergoing complex percutaneous coronary artery revascularization: from the WIN-DES collaborative patient-level pooled analysis. JACC Cardiovasc Interv. 2016;9:674–684.
  • Colombo A, Chieffo A, Frasheri A, et al. Second-generation drug-eluting stent implantation followed by 6- versus 12-month dual antiplatelet therapy: the SECURITY randomized clinical trial. J Am Coll Cardiol. 2014;64:2086–2097.
  • Gilard M, Barragan P, Noryani AAL, et al. 6- versus 24-month dual antiplatelet therapy after implantation of drug-eluting stents in patients nonresistant to aspirin: the randomized, multicenter ITALIC trial. J Am Coll Cardiol. 2015;65:777–786.
  • Giustino G, Baber U, Sartori S, et al. Duration of dual antiplatelet therapy after drug-eluting stent implantation: a systematic review and meta-analysis of randomized controlled trials. J Am Coll Cardiol. 2015;65:1298–1310.
  • Schulz-Schupke S, Byrne RA, Ten Berg JM, et al. ISAR-SAFE: a randomized, double-blind, placebo-controlled trial of 6 vs. 12 months of clopidogrel therapy after drug-eluting stenting. Eur Heart J. 2015;36:1252–1263.
  • Feres F, Costa RA, Abizaid A, et al. Three vs twelve months of dual antiplatelet therapy after zotarolimus-eluting stents: the OPTIMIZE randomized trial. Jama. 2013;310:2510–2522.
  • Kim BK, Hong MK, Shin DH, et al. A new strategy for discontinuation of dual antiplatelet therapy: the RESET trial (REal safety and efficacy of 3-month dual antiplatelet therapy following endeavor zotarolimus-eluting stent implantation). J Am Coll Cardiol. 2012;60:1340–1348.
  • Piccolo R, Giustino G, Mehran R, et al. Stable coronary artery disease: revascularisation and invasive strategies. Lancet. 2015;386:702–713.
  • Faggioni M, Baber U, Sartori S, et al. Incidence, patterns, and associations between dual-antiplatelet therapy cessation and risk for adverse events among patients with and without diabetes mellitus receiving drug-eluting stents: results from the PARIS registry. JACC Cardiovasc Interv. 2017;10:645–654.
  • Mehran R, Baber U, Steg PG, et al. Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study. Lancet. 2013;382:1714–1722.
  • Mauri L, Kereiakes DJ, Yeh RW, et al. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med. 2014;371:2155–2166.
  • Costa F, van Klaveren D, James S, et al. Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: a pooled analysis of individual-patient datasets from clinical trials. Lancet. 2017;389:1025–1034.
  • Yeh RW, Secemsky EA, Kereiakes DJ, et al. Development and validation of a prediction rule for benefit and harm of dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention. Jama. 2016;315:1735–1749.
  • Giustino G, Chieffo A, Palmerini T, et al. Efficacy and safety of dual antiplatelet therapy after complex PCI. J Am Coll Cardiol. 2016;68:1851–1864.
  • Yusuf S, Zhao F, Mehta SR, et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. New England J Med. 2001;345:494–502.
  • Mehta SR, Yusuf S, Peters RJG, et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. The Lancet. 2001;358:527–533.
  • Chen ZM, Jiang LX, Chen YP, et al. Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005;366:1607–1621.
  • Dean L. Clopidogrel Therapy and CYP2C19 Genotype. In: Pratt V, McLeod H, Dean L, et al., editors. Medical Genetics Summaries. Bethesda (MD): National Center for Biotechnology; 2012:2.
  • Holmes MV, Perel P, Shah T, et al. CYP2C19 genotype, clopidogrel metabolism, platelet function, and cardiovascular events: a systematic review and meta-analysis. Jama. 2011;306:2704–2714.
  • Tantry US, Bonello L, Aradi D, et al. Consensus and update on the definition of on-treatment platelet reactivity to adenosine diphosphate associated with ischemia and bleeding. J Am Coll Cardiol. 2013;62:2261–2273.
  • Stone GW, Witzenbichler B, Weisz G, et al. Platelet reactivity and clinical outcomes after coronary artery implantation of drug-eluting stents (ADAPT-DES): a prospective multicentre registry study. Lancet. 2013;382:614–623.
  • Giustino G, Redfors B, Mehran R, et al. Sex differences in the effect of diabetes mellitus on platelet reactivity and coronary thrombosis: from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents (ADAPT-DES) study. Int J Cardiol. 2017;246:20–25.
  • Redfors B, Ben-Yehuda O, Lin SH, et al. Quantifying ischemic risk after percutaneous coronary intervention attributable to high platelet reactivity on clopidogrel (from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents study). Am J Cardiol. 2017;120:917–923.
  • Giustino G, Kirtane AJ, Baber U, et al. Impact of anemia on platelet reactivity and ischemic and bleeding risk: from the assessment of dual antiplatelet therapy with drug-eluting stents study. Am J Cardiol. 2016;117:1877–1883.
  • Giustino G, Kirtane AJ, Genereux P, et al. Relation between platelet count and platelet reactivity to thrombotic and bleeding risk: from the assessment of dual antiplatelet therapy with drug-eluting stents study. Am J Cardiol. 2016;117:1703–1713.
  • Franchi F, Angiolillo DJ. Novel antiplatelet agents in acute coronary syndrome. Nat Rev Cardiol. 2015;12:30–47.
  • Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361:1045–1057.
  • Wiviott SD, Braunwald E, McCabe CH, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007;357:2001–2015.
  • Giustino G, Mehran R, Dangas GD, et al. Characterization of the average daily ischemic and bleeding risk after primary PCI for STEMI. J Am Coll Cardiol. 2017;70:1846–1857.
  • Stone GW, Maehara A, Lansky AJ, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364:226–235.
  • Lee JM, Cho DK, Hahn JY, et al. Safety of 6-month duration of dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndromes: rationale and design of the smart angioplasty research team-safety of 6-month duration of dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndromes (SMART-DATE) prospective multicenter randomized trial. Am Heart J. 2016;182:1–8.
  • Suryapranata H Reduce: a randomized trial of 3-month vs 12-month DAPT after implantation of a bioabsorbable polymer-based metallic DES with a luminal CD34+ antibody coating in patients with ACS. Presented at Transcatheter Cardiovascular Therapeutics 2017.
  • Yeh RW, Kereiakes DJ, Steg PG, et al. Benefits and risks of extended duration dual antiplatelet therapy after PCI in patients with and without acute myocardial infarction. J Am Coll Cardiol. 2015;65:2211–2221.
  • Urban P, Meredith IT, Abizaid A, et al. Polymer-free drug-coated coronary stents in patients at high bleeding risk. N Engl J Med. 2015;373:2038–2047.
  • Collet JP, Cuisset T, Rangé G, et al. Bedside monitoring to adjust antiplatelet therapy for coronary stenting. Nejm. 2012;367:2100–2109.
  • Price MJ, Berger PB, Tierstein PS, et al. Standard-vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. JAMA. 2011;305:1097–1105.
  • Notarangelo FM, Maglietta G, Bevilacqua P, et al. Pharmacogenomic approach to selecting antiplatelet therapy in patients with acute coronary syndromes: the PHARMCLO trial. J Am Coll Cardiol. 2018;71:1869–1877.
  • Tuteja DS. Assessment of prospective CYP2C19 genotype guided dosing of antiplatelet therapy in percutaneous coronary intervention (ADAPT-PCI). Am Coll Cardiol 67th Annu Scientific Session. 2018 March 10;2018(ed):25.
  • Wilson SJ, Newby DE, Dawson D, et al. Duration of dual antiplatelet therapy in acute coronary syndrome. Heart. 2017;103:573-580.
  • Bagai A, Peterson ED, Honeycutt E, et al. In-hospital switching between adenosine diphosphate receptor inhibitors in patients with acute myocardial infarction treated with percutaneous coronary intervention: insights into contemporary practice from the TRANSLATE-ACS study. Eur Heart J Acute Cardiovasc Care. 2015;4:499–508.
  • Sibbing D, Aradi D, Jacobshagen C, et al. Guided de-escalation of antiplatelet treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention (TROPICAL-ACS): a randomised, open-label, multicentre trial. The Lancet. 2017;390:1747–1757.
  • Cuisset T, Deharo P, Quilici J, et al. Benefit of switching dual antiplatelet therapy after acute coronary syndrome: the TOPIC (timing of platelet inhibition after acute coronary syndrome) randomized study. Eur Heart J. 2017;38:3070–3078.
  • Udell JA, Bonaca MP, Collet J-P, et al. Long-term dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials. Eur Heart J. 2016;37:390–399.
  • Mohr FW, Morice MC, Kappetein AP, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet. 2013;381:629–638.
  • Head SJ, Milojevic M, Daemen J, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. Lancet. 2018;391:939–948.
  • Baber U, Kini AS, Sharma SK. Stenting of complex lesions: an overview. Nat Rev Cardiol. 2010;7:485–496.
  • Stone GW, Hochman JS, Williams DO, et al. Medical therapy with versus without revascularization in stable patients with moderate and severe ischemia: the case for community equipoise. J Am Coll Cardiol. 2016;67:81–99.
  • Hannan EL, Wu C, Walford G, et al. Incomplete revascularization in the era of drug-eluting stents: impact on adverse outcomes. JACC Cardiovasc Interv. 2009;2:17–25.
  • Colombo A, Hall P, Nakamura S, et al. Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance. Circulation. 1995;91:1676–1688.
  • Palmerini T, Calabro P, Piscione F, et al. Impact of gene polymorphisms, platelet reactivity, and the SYNTAX score on 1-year clinical outcomes in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention: the GEPRESS study. JACC Cardiovasc Interv. 2014;7:1117–1127.
  • Hong SJ, Shin DH, Kim JS, et al. 6-month versus 12-month dual-antiplatelet therapy following long everolimus-eluting stent implantation: the IVUS-XPL randomized clinical trial. JACC Cardiovasc Interv. 2016;9:1438–1446.
  • Hong SJ, Kim BK, Shin DH, et al. Effect of intravascular ultrasound-guided vs angiography-guided everolimus-eluting stent implantation: the IVUS-XPL randomized clinical trial. Jama. 2015;314:2155–2163.
  • Yeh RW, Kereiakes DJ, Steg PG, et al. Lesion complexity and outcomes of extended dual antiplatelet therapy after percutaneous coronary intervention. J Am Coll Cardiol. 2017;70:2213–2223.
  • Redfors B, Genereux P, Witzenbichler B, et al. Percutaneous coronary intervention of bifurcation lesions and platelet reactivity. Int J Cardiol. 2018;250:92–97.
  • Suh J, Park DW, Lee JY, et al. The relationship and threshold of stent length with regard to risk of stent thrombosis after drug-eluting stent implantation. JACC Cardiovasc Interv. 2010;3:383–389.
  • Waksman R, Kirtane AJ, Torguson R, et al. Correlates and outcomes of late and very late drug-eluting stent thrombosis: results from DESERT (International Drug-Eluting Stent Event Registry of Thrombosis). JACC Cardiovasc Interv. 2014;7:1093–1102.

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