TY - JOUR
T1 - Outcomes of percutaneous coronary intervention performed with or without preprocedural dual antiplatelet therapy
AU - Ikegami, Yukinori
AU - Kohsaka, Shun
AU - Miyata, Hiroaki
AU - Ueda, Ikuko
AU - Fuse, Jun
AU - Sakamoto, Munehisa
AU - Shiraishi, Yasuyuki
AU - Numasawa, Yohei
AU - Negishi, Koji
AU - Nakamura, Iwao
AU - Maekawa, Yuichiro
AU - Momiyama, Yukihiko
AU - Fukuda, Keiichi
N1 - Publisher Copyright:
© 2015, Japanese Circulation Society. All rights reserved.
PY - 2015/11/25
Y1 - 2015/11/25
N2 - 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.
AB - 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.
KW - Bleeding
KW - Dual antiplatelet therapy
KW - Japanese
KW - Percutaneous coronary intervention
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U2 - 10.1253/circj.CJ-15-0484
DO - 10.1253/circj.CJ-15-0484
M3 - Article
C2 - 26447105
AN - SCOPUS:84961651959
VL - 79
SP - 2598
EP - 2607
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 12
ER -