Differential impact of abluminal groove-filled biodegradable-polymer sirolimus-eluting stent versus durable-polymer everolimus-eluting stent on and off dual antiplatelet therapy
| Autor: | Henning Kelbæk, Marie-Angèle Morel, Ming Zheng, Yuichi Saito, Alexandra J. Lansky, Target Ac Investigators, Volker Schächinger, William Wijns, Andreas Baumbach, Richard Anderson, Bo Xu |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome animal structures Polymers medicine.medical_treatment Coronary Artery Disease 030204 cardiovascular system & hematology Revascularization Coronary artery disease 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Internal medicine Absorbable Implants Medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Myocardial infarction Everolimus Sirolimus business.industry Percutaneous coronary intervention Stent Drug-Eluting Stents General Medicine medicine.disease Discontinuation Treatment Outcome Drug-eluting stent Cardiology Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors |
| Zdroj: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventionsREFERENCES. 99(2) |
| ISSN: | 1522-726X |
| Popis: | Background Current guidelines recommend dual antiplatelet therapy (DAPT) following percutaneous coronary intervention for 6-12 months in patients with acute coronary syndrome (ACS) and 3-6 months in those with chronic coronary syndromes (CCS). Whether DAPT duration has a differential effect on outcomes following treatment of ischemic coronary disease with durable versus biodegradable drug-eluting stent (DES) is poorly defined. Methods The TARGET All Comer study was a randomized trial of patients with ischemic coronary artery disease assigned to treatment with either a biodegradable polymer DES (Firehawk) or a durable polymer DES (XIENCE). This pre-specified TARGET AC sub-analysis sought to evaluate the 2-year clinical outcomes before and after DAPT discontinuation. The primary endpoint was target lesion failure (TLF). Results A total of 1,296 (78.4%) of 1,653 randomized patients were included in this substudy, of which 1,210 (93.4%) remained on DAPT at 6 months, 863 (66.6%) at 12 months, and 409 (31.6%) at 2 years. There was no difference in TLF between patients treated with Firehawk and XIENCE stents from index procedure to DAPT discontinuation (8.0 and 7.7%, p > .99) or after DAPT discontinuation (2.9 vs. 3.8%, p = .16). After DAPT discontinuation, target vessel myocardial infarction (1.3 vs. 3.3%, p = .07), and ischemia-driven target lesion revascularization (0.5 vs. 1.9%, p = .06) favored treatment with Firehawk. Conclusions Although TLF was comparable for both Firehawk and XIENCE stent groups before and after DAPT discontinuation, after DAPT discontinuation, there was a trend for less target vessel myocardial infarction and ischemia-driven revascularization with the biodegradable polymer DES. |
| Databáze: | OpenAIRE |
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