Publish in this journal
Journal Information
Vol. 76. Issue 4.
Pages 245-252 (April 2023)
Share
Share
Download PDF
More article options
ePub
Visits
Not available
Vol. 76. Issue 4.
Pages 245-252 (April 2023)
Artículo original
Tratamiento antiagregante plaquetario doble tras la intervención coronaria percutánea del tronco coronario izquierdo
Dual antiplatelet therapy after percutaneous coronary intervention for left main coronary artery disease
Sungsoo Choa,, Do-Yoon Kangb,, Jung-Sun Kimc,
Corresponding author
kjs1218@yuhs.ac

Autores para correspondencia.
, Duk-Woo Parkb,
Corresponding author
dwpark@amc.seoul.kr

Autores para correspondencia.
, In-Soo Kimd, Tae Soo Kange, Jung-Min Ahnb, Pil Hyung Leeb, Soo-Jin Kangb, Seung-Whan Leeb, Young-Hak Kimb, Cheol Whan Leeb, Seong-Wook Parkb, Seung-Jun Leec, Sung-Jin Hongc, Chul-Min Ahnc, Byeong-Keuk Kimc, Young-Guk Koc, Donghoon Choic, Yangsoo Jangf..., Myeong-Ki Hongc, Seung-Jung ParkbVer más
a Department of Cardiology, Heart and Brain Hospital, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Gyeonggi-do, República de Corea
b Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seúl, República de Corea
c Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seúl, República de Corea
d Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seúl, República de Corea
e Division of Cardiovascular Medicine, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Choongcheongnam-do, República de Corea
f Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, República de Corea
Related content
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (4)
Show moreShow less
Resumen
Introducción y objetivos

Son escasos los datos sobre la duración y el impacto pronóstico del tratamiento antiagregante plaquetario doble (TAPD) tras una intervención coronaria percutánea (ICP) del tronco coronario izquierdo (TCI) con stents farmacoactivos de segunda generación. El objetivo de este estudio es investigar los patrones de prescripción y el efecto pronóstico a largo plazo de la duración del TAPD en pacientes sometidos a ICP del TCI con stents farmacoactivos segunda generación.

Métodos

A partir de los datos individuales de los registros IRIS-MAIN y KOMATE, se incluyó a 1.827 pacientes sometidos a ICP del TCI con stents farmacoactivos de segunda generación de los que hubiese información válida sobre la duración del TAPD. El objetivo de eficacia fue la aparición de eventos cardiovasculares adversos mayores (MACE) (un combinado de muerte cardiaca, infarto de miocardio y trombosis del stent) y el de seguridad fue la presencia de hemorragia mayor según TIMI.

Resultados

Las duraciones del TAPD fueron <6 meses (n=273), de 6-12 meses (n=477), de 12-24 meses (n=637) y ≥ 24 meses (n=440). La mediana de la duración del seguimiento fue de 3,9 [intervalo intercuartílico, 3,01-5,00] años. El TAPD prolongado se asoció con menor incidencia de MACE. En el análisis de puntuación de propensión multigrupo, las HR ajustadas de los MACE fueron significativamente mayores con los TAPD de menos de 6 meses y de 6-12 meses (HR=4,51; IC95%, 2,96-6,88) frente al TAPD de 12-24 meses (HR=1,92; IC95%, 1,23-3,00). No hubo diferencias en la HR de hemorragia mayor entre los grupos evaluados.

Conclusiones

La duración del TAPD tras la ICP para la enfermedad del TCI es muy variable. Aunque debe considerarse en función de la situación clínica de cada paciente, un TAPD de menos de 12 meses se asoció con mayor incidencia de MACE.

Palabras clave:
Tratamiento antiagregante plaquetario doble
Enfermedad del tronco coronario izquierdo
Stents farmacoactivos
Abreviaturas:
ICP
MACE
SFA
TAPD
TCI
TS
Abstract
Introduction and objectives

There are scarce data on the optimal duration and prognostic impact of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents for left main coronary artery (LMCA) disease. The aim of this study was to investigate the practice pattern and long-term prognostic effect of DAPT duration in patients undergoing PCI with second-generation drug-eluting stents for LMCA disease.

Methods

Using individual patient-level data from the IRIS-MAIN and KOMATE registries, 1827 patients undergoing PCI with second-generation drug-eluting stents for LMCA disease with valid information on DAPT duration were included. The efficacy outcome was major adverse cardiovascular events (MACE, a composite of cardiac death, myocardial infarction, and stent thrombosis) and the safety outcome was TIMI major bleeding.

Results

DAPT duration was <6 months (n=273), 6 to 12 months (n=477), 12 to 24 months (n=637), and ≥ 24 months (n=440). The median follow-up duration was 3.9 [interquartile range, 3.01-5.00] years. Prolonged DAPT duration was associated with lower incidences of MACE. In multigroup propensity score analysis, adjusted HR for MACE were significantly higher for DAPT <6 months and DAPT 6 to 12 months than for DAPT 12 to 24 months (HR, 4.51; 95%CI, 2.96-6.88 and HR 1.92; 95%CI, 1.23-3.00). There was no difference in HR for major bleeding among the assessed groups.

Conclusions

DAPT duration following PCI for LMCA disease is highly variable. Although the duration of DAPT should be considered in the context of the clinical situation of each patient, <12 months of DAPT was associated with higher incidence of MACE. Registration identifiers: NCT01341327; NCT03908463.

Keywords:
Dual antiplatelet therapy
Left main coronary artery disease
Drug-eluting stents

Article

These are the options to access the full texts of the publication Revista Española de Cardiología (English Edition)
Member
Members of SEC
Use the Society's website login and password here
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Cardiología (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

View newsletter history
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?