Dual Antiplatelet Therapy Duration After the Placement of a Drug-Eluting Stent: What Are the Data?
详细信息    查看全文
  • 作者:Jad Raffoul MD (1)
    Andrew J. P. Klein MD
    ; FACC ; FSCAI (1) (2)

    1. Department of Internal Medicine
    ; Saint Louis University School of Medicine ; 1402 South Grand Blvd. ; Saint Louis ; MO ; 63104 ; USA
    2. Department of Internal Medicine
    ; Division of Cardiology ; St. Louis VA Healthcare System - The John Cochran VA Medical Center ; 915 North Grand Blvd. ; Saint Louis ; MO ; 63106 ; USA
  • 关键词:Dual antiplatelet therapy (DAPT) ; Drug ; eluting stents (DESs) ; Data ; Implantation
  • 刊名:Current Treatment Options in Cardiovascular Medicine
  • 出版年:2015
  • 出版时间:March 2015
  • 年:2015
  • 卷:17
  • 期:3
  • 全文大小:240 KB
  • 参考文献:1. Stettler, C (2007) Outcomes associated with drug-eluting and bare-metal stents: a collaborative network meta-analysis. Lancet 370: pp. 937-48 CrossRef
    2. Kotani, J (2006) Incomplete neointimal coverage of sirolimus-eluting stents: angioscopic findings. J Am Coll Cardiol 47: pp. 2108-11 CrossRef
    3. Nakazawa, G (2008) Delayed arterial healing and increased late stent thrombosis at culprit sites after drug-eluting stent placement for acute myocardial infarction patients: an autopsy study. Circulation 118: pp. 1138-45 CrossRef
    4. Ueda, Y (1994) Neointimal coverage of stents in human coronary arteries observed by angioscopy. J Am Coll Cardiol 23: pp. 341-6 CrossRef
    5. Joner, M (2006) Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 48: pp. 193-202 CrossRef
    6. Chen, ZM (2005) Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 366: pp. 1607-21 CrossRef
    7. Mehta, SR (2001) Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 358: pp. 527-33 CrossRef
    8. Sabatine, MS (2005) Effect of clopidogrel pretreatment before percutaneous coronary intervention in patients with ST-elevation myocardial infarction treated with fibrinolytics: the PCI-CLARITY study. JAMA 294: pp. 1224-32 CrossRef
    9. Yusuf, S (2001) Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 345: pp. 494-502 CrossRef
    10. Butler, MJ (2009) The effect of intended duration of clopidogrel use on early and late mortality and major adverse cardiac events in patients with drug-eluting stents. Am Heart J 157: pp. 899-907 CrossRef
    11. Eisenstein, EL (2007) Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation. JAMA 297: pp. 159-68 CrossRef
    12. Pfisterer, M (2006) Late clinical events after clopidogrel discontinuation may limit the benefit of drug-eluting stents: an observational study of drug-eluting versus bare-metal stents. J Am Coll Cardiol 48: pp. 2584-91 CrossRef
    13. Werkum, JW (2009) Predictors of coronary stent thrombosis: the Dutch Stent Thrombosis Registry. J Am Coll Cardiol 53: pp. 1399-409 CrossRef
    14. Levine, GN (2011) ACCF/AHA/SCAI guideline for percutaneous coronary intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol 58: pp. e44-122 CrossRef
    15. Wijns W et al. Task Force on Myocardial Revascularization of the European Society of Cardio-Thoracic Surgery (EACTS) et al. Guidelines on myocardial revascularization. Eur Heart J. 2010;31(20):2501鈥?5.
    16. Iwata, Y (2008) Incidence of premature discontinuation of antiplatelet therapy after sirolimus-eluting stent implantation. Circ J 72: pp. 340-1 CrossRef
    17. Spertus, JA (2006) Prevalence, predictors, and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement: results from the PREMIER registry. Circulation 113: pp. 2803-9 CrossRef
    18. Varenhorst, C (2014) Duration of dual antiplatelet treatment with clopidogrel and aspirin in patients with acute coronary syndrome. Eur Heart J 35: pp. 969-78 CrossRef
    19. Kedhi, E (2012) Stent thrombosis: insights on outcomes, predictors and impact of dual antiplatelet therapy interruption from the SPIRIT II, SPIRIT III, SPIRIT IV and COMPARE trials. Eur Interv 8: pp. 599-606
    20. Park, SJ (2010) Duration of dual antiplatelet therapy after implantation of drug-eluting stents. N Engl J Med 362: pp. 1374-82 CrossRef
    21. Valgimigli, M (2012) Short- versus long-term duration of dual-antiplatelet therapy after coronary stenting: a randomized multicenter trial. Circulation 125: pp. 2015-26 CrossRef
    22. Lee, CW (2014) Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: a randomized, controlled trial. Circulation 129: pp. 304-12 CrossRef
    23. Galper BZ, Mauri L. Antiplatelet therapy after coronary stenting. Curr Treat Options Cardiovasc Med. 2013;15(1):1鈥?0. A review article making the observation that prolonging dual antiplatelet therapy seemed to improve the outcomes of the patients involved and that while newer agents such as ticagrelor and prasugrel seem more effective in diminishing the risk of cardiac events post PCI, they have been associated with higher chances of bleeding. They recommend that until larger and better-powered studies are available to evaluate stent thrombosis, myocardial infarction, bleeding and death, dual antiplatelet therapy ought to be used for at the least 6 to 12聽months. They also question whether duration of therapy should or will be dependent on the nature of newer generation stents.
    24. Mauri, L (2014) Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med 371: pp. 2156-66 CrossRef
    25. Colombo, A, Chieffo, A (2014) Dual antiplatelet therapy after drug-eluting stents鈥攈ow long to treat?. N Engl J Med 371: pp. 2225-6 CrossRef
    26. Garratt, KN (2014) Prasugrel plus aspirin beyond 12 months is associated with improved outcomes after taxus liberte paclitaxel-eluting coronary stent placement. Circulation 313: pp. 62-73
    27. Fiedler KA et al. Randomised, double-blind trial on the value of tapered discontinuation of clopidogrel maintenance therapy after drug-eluting stent implantation. Intracoronary Stenting and Antithrombotic Regimen: CAUTION in Discontinuing Clopidogrel Therapy鈥擨SAR-CAUTIO. Thromb Haemost. 2014;111(6):1041鈥?. Double-blinded, randomized controlled trial to assess abrupt discontinuation of clopidogrel vs. gradual 4-week taper, 90聽days after the drug-eluting stent had been placed. This trial was stopped prematurely as a result of slow enrollment, attributed to the lack of routine follow-up at the time of discontinuation, and no significant difference was noted in composite of cardiac death, myocardial infarction, stent thrombosis, stroke, major bleed, or ACS requiring re-hospitalization.
    28. Gwon, HC (2012) Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents: the Efficacy of Xience/Promus Versus Cypher to Reduce Late Loss After Stenting (EXCELLENT) randomized, multicenter study. Circulation 125: pp. 505-13 CrossRef
    29. Kim, BK (2012) 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 60: pp. 1340-8 CrossRef
    30. Camenzind E et al. Stent thrombosis and major clinical events at 3聽years after zotarolimus-eluting or sirolimus-eluting coronary stent implantation: a randomised, multicentre, open-label, controlled trial. Lancet. 2012;380(9851):1396鈥?05.
    31. Feres, F (2013) Three vs twelve months of dual antiplatelet therapy after zotarolimus-eluting stents: the OPTIMIZE randomized trial. JAMA 310: pp. 2510-22
    32. Gilard M, et al. Six-month versus 24-month dual antiplatelet therapy after implantation of drug eluting stents in patients non-resistant to aspirin: ITALIC, a randomized multicenter trial. J Am Coll Cardiol. 2014.
    33. El-Hayek G et al. Meta-analysis of randomized clinical trials comparing short-term versus long-term dual antiplatelet therapy following drug-eluting stents. Am J Cardiol. 2014;114(2):236鈥?2. Meta-analysis of randomized controlled trials comparing short (<6聽months) vs. long (鈮?2聽months) duration dual antiplatelet therapy after drug-eluting stent placement, with close attention to the EXCELLENT, RESET, PRODIGY, and OPTIMIZE trials. A higher, albeit non-significant, rate of stent thrombosis in the shorter duration group was noted, and no significant difference in adverse cardiac events was demonstrated; there was a significant increased risk of major bleeding with the prolonged group. In several of the trials, stent thrombosis was noted to occur early in the course of the study, thus making them unable to attribute the events to short duration of DAPT.
    34. Dafni, U (2011) Landmark analysis at the 25-year landmark point. Circ Cardiovasc Qual Outcomes 4: pp. 363-71 CrossRef
    35. Colombo, A (2014) Second generation drug-eluting stents implantation followed by six versus twelve-month鈥攄ual antiplatelet therapy- the SECURITY randomized clinical trial. J Am Coll Cardiol 64: pp. 2086-97 CrossRef
    36. Holmes, DR (2014) Art and science. J Am Coll Cardiol 64: pp. 2098-100 CrossRef
    37. Byrne RA et al. Rationale and design of a randomized, double-blind, placebo-controlled trial of 6 versus 12聽months clopidogrel therapy after implantation of a drug-eluting stent: the Intracoronary Stenting and Antithrombotic Regimen: Safety And EFficacy of 6 Months Dual Antiplatelet Therapy After Drug-Eluting Stenting (ISAR-SAFE) study. Am Heart J. 2009;157(4):620鈥? e2.
    38. Iakovou, I (2005) Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA 293: pp. 2126-30 CrossRef
    39. Kuchulakanti, PK (2006) Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents. Circulation 113: pp. 1108-13 CrossRef
    40. Ong, AT (2005) Thirty-day incidence and six-month clinical outcome of thrombotic stent occlusion after bare-metal, sirolimus, or paclitaxel stent implantation. J Am Coll Cardiol 45: pp. 947-53 CrossRef
    41. Park, DW (2006) Frequency of and risk factors for stent thrombosis after drug-eluting stent implantation during long-term follow-up. Am J Cardiol 98: pp. 352-6 CrossRef
    42. Kastrati A, et al. Intracoronary stenting and angiographic results strut thickness effect on restenosis outcome (ISAR-STEREO) Trial. Vestn Rentgenol Radiol. 2012;(2):52鈥?0.
    43. Kereiakes, DJ (2004) Thrombosis and drug-eluting stents: a critical appraisal. Rev Cardiovasc Med 5: pp. 9-15 CrossRef
    44. Orford, JL (2002) Frequency and correlates of coronary stent thrombosis in the modern era: analysis of a single center registry. J Am Coll Cardiol 40: pp. 1567-72 CrossRef
    45. Silva, JA (1999) Primary stenting in acute myocardial infarction: influence of diabetes mellitus in angiographic results and clinical outcome. Am Heart J 138: pp. 446-55 CrossRef
    46. Roy, P (2008) The potential clinical utility of intravascular ultrasound guidance in patients undergoing percutaneous coronary intervention with drug-eluting stents. Eur Heart J 29: pp. 1851-7 CrossRef
    47. Doostzadeh, J (2010) Recent progress in percutaneous coronary intervention: evolution of the drug-eluting stents, focus on the XIENCE V drug-eluting stent. Coron Artery Dis 21: pp. 46-56 CrossRef
    48. Lange, RA, Hillis, LD (2010) Second-generation drug-eluting coronary stents. N Engl J Med 362: pp. 1728-30 CrossRef
    49. Valgimigli, M (2013) Should duration of dual antiplatelet therapy depend on the type and/or potency of implanted stent? A pre-specified analysis from the PROlonging Dual antiplatelet treatment after Grading stent-induced Intimal hyperplasia studY (PRODIGY). Eur Heart J 34: pp. 909-19 CrossRef
    50. Wallentin, L (2009) Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 361: pp. 1045-57 CrossRef
    51. Wiviott, SD (2007) Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 357: pp. 2001-15 CrossRef
    52. Helft G et al. Efficacy and safety of 12 versus 48聽months of dual antiplatelet therapy after implantation of a drug-eluting stent: the OPTImal DUAL antiplatelet therapy (OPTIDUAL) trial: study protocol for a randomized controlled trial. Trials. 2013;14:56. The results of this study are still not published; however, what differentiates this study from DAPT apart from duration of the prolonged arm which was 30聽months with DAPT is the exclusion of patients with known malignancy; in DAPT, there was a high rate of cancer-related deaths with the prolonged therapy group, which significantly decreased when these patients were excluded in post hoc analysis.
  • 刊物主题:Cardiology;
  • 出版者:Springer US
  • ISSN:1534-3189
文摘

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700