Geographical Variations in Patterns of DAPT Cessation and Two-Year PCI Outcomes: Insights from the PARIS Registry
| Autor: | Birgit Vogel, Giora Weisz, C. Michael Gibson, Ioannis Iakovou, Annapoorna Kini, Serdar Farhan, Sabato Sorrentino, Michela Faggioni, Antonio Colombo, Philippe Gabriel Steg, Bernhard Witzenbichler, Jaya Chandrasekhar, Alaide Chieffo, David J. Cohen, Thomas D. Stuckey, Cono Ariti, George Dangas, Stuart J. Pocock, Roxana Mehran, Usman Baber, Ioannis Mastoris, Samantha Sartori, Melissa Aquino, Mitchell W. Krucoff, David J. Moliterno, Timothy D. Henry |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty animal structures Incidence (epidemiology) medicine.medical_treatment Percutaneous coronary intervention Hematology 030204 cardiovascular system & hematology medicine.disease 3. Good health Discontinuation 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Internal medicine Conventional PCI medicine Stent implantation In patient Observational study Myocardial infarction Prospective cohort study |
| Zdroj: | ORCID Microsoft Academic Graph |
| ISSN: | 2567-689X 0340-6245 |
| DOI: | 10.1055/s-0039-1693463 |
| Popis: | Background Data on geographical variations in dual antiplatelet therapy (DAPT) cessation and the impact on outcomes after percutaneous coronary intervention (PCI) are limited. We sought to evaluate geographical patterns of DAPT cessation and associated outcomes in patients undergoing PCI in the United States versus Europe. Methods Analyzing data from the PARIS registry, we studied 3,660 U.S. patients (72.9%) and 1,358 European patients (27.1%) that underwent PCI with stent implantation. DAPT cessation was classified as physician-recommended discontinuation, interruption (< 14 days), or disruption due to bleeding or noncompliance. The primary endpoint was 2-year major adverse cardiovascular events (MACE) defined as a composite of cardiac death, stent thrombosis, myocardial infarction, or target lesion revascularization. Results Cardiovascular risk factors were more common in the United States, whereas procedural complexity was greater in Europe. The incidence of 2-year DAPT discontinuation was significantly lower in U.S. versus European patients (30.7% vs. 65.6%; p Conclusion DAPT cessation patterns, along with clinical and angiographic risk, vary substantially between PCI patients in the U.S. versus Europe. Despite such differences, cardiovascular risk associated with DAPT cessation remains uniform. |
| Databáze: | OpenAIRE |
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