Outcomes of percutaneous coronary intervention performed with or without preprocedural dual antiplatelet therapy

Yukinori Ikegami, Shun Kohsaka, Hiroaki Miyata, Ikuko Ueda, Jun Fuse, Munehisa Sakamoto, Yasuyuki Shiraishi, Yohei Numasawa, Koji Negishi, Iwao Nakamura, Yuichiro Maekawa, Yukihiko Momiyama, Keiichi Fukuda

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8 Citations (Scopus)

Abstract

Background:Preprocedural dual antiplatelet therapy (DAPT) in percutaneous coronary interventions (PCI) has been shown to improve outcomes; however, the efficacy of the procedure and its complications in Japanese patients remain largely unexplored, so we examined the risks and benefits of DAPT before PCI and its association with in-hospital outcomes.Methods and Results:We analyzed data from patients who had undergone PCI at 12 centers within the metropolitan Tokyo area between September 2008 and September 2013.Our study group comprised 6,528 patients, of whom 2,079 (31.8%) were not administered preprocedural DAPT. Non-use of preprocedural DAPT was associated with death, postprocedural shock, or heart failure (odds ratio [OR]: 1.47, 95% confidence interval [CI]: 1.10–1.96, P=0.009), and postprocedural myocardial infarction (OR: 1.41, 95% CI: 1.18–1.69, P<0.001) after adjusting propensity scores for known predictors of in-hospital complications. Non-use of DAPT was not associated with procedure-related bleeding complications (OR: 0.98, 95% CI: 0.71–1.59, P=0.764).Conclusions:Approximately one-third of the patients who underwent PCI did not receive preprocedural DAPT despite guideline recommendations. Our results indicate that patients undergoing PCI with DAPT have a lower risk of postprocedural cardiac events without any increased bleeding risk. Further studies are needed to implement the use of DAPT in real-world PCI.

Original languageEnglish
Pages (from-to)2598-2607
Number of pages10
JournalCirculation Journal
Volume79
Issue number12
DOIs
Publication statusPublished - 2015 Nov 25

Keywords

  • Bleeding
  • Dual antiplatelet therapy
  • Japanese
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Ikegami, Y., Kohsaka, S., Miyata, H., Ueda, I., Fuse, J., Sakamoto, M., Shiraishi, Y., Numasawa, Y., Negishi, K., Nakamura, I., Maekawa, Y., Momiyama, Y., & Fukuda, K. (2015). Outcomes of percutaneous coronary intervention performed with or without preprocedural dual antiplatelet therapy. Circulation Journal, 79(12), 2598-2607. https://doi.org/10.1253/circj.CJ-15-0484