One-year clinical outcome of biodegradable polymer sirolimus-eluting stent in patients needing short dual antiplatelet therapy. Insight from the ULISSE registry (ULtimaster Italian multicenter all comerS Stent rEgistry)

Autor: David Rutigliano, Carlo Briguori, Bernhard Reimers, Valeria Magni, Alberto Benassi, Nicola Locuratolo, Giuseppe Ferrante, Giulia Perfetti, Carlo Andrea Pivato, Antonio L. Bartorelli, Alberto Margonato, Maurizio Tespili, Mauro Chiarito, Stefania Falcone, Alessandro Beneduce, Adele Pierri, Stefano De Martini, Angelo Anzuini, Alfonso Ielasi, Antonio Colombo, Cosmo Godino, Franco Fabbiocchi, Rosario Parisi, Alberto Cappelletti, Matteo Montorfano, Eugenio Prati
Přispěvatelé: Godino, Cosmo, Beneduce, Alessandro, Ferrante, Giuseppe, Ielasi, Alfonso, Pivato, Carlo Andrea, Chiarito, Mauro, Cappelletti, Alberto, Perfetti, Giulia, Magni, Valeria, Prati, Eugenio, Falcone, Stefania, Pierri, Adele, De Martini, Stefano, Montorfano, Matteo, Parisi, Rosario, Rutigliano, David, Locuratolo, Nicola, Anzuini, Angelo, Tespili, Maurizio, Margonato, Alberto, Benassi, Alberto, Briguori, Carlo, Fabbiocchi, Franco, Reimers, Bernhard, Bartorelli, Antonio, Colombo, Antonio
Rok vydání: 2019
Předmět:
medicine.medical_specialty
animal structures
Time Factors
Stent thrombosi
Polymers
medicine.medical_treatment
Thrombogenicity
030204 cardiovascular system & hematology
Percutaneous coronary intervention
03 medical and health sciences
0302 clinical medicine
Biodegradable polymer sirolimus-eluting stent
Absorbable Implants
Medicine
Humans
In patient
030212 general & internal medicine
Registries
Acute Coronary Syndrome
Target lesion revascularization
Aged
Retrospective Studies
Aged
80 and over
Sirolimus
business.industry
Stent
Drug-Eluting Stents
Middle Aged
Discontinuation
Surgery
Treatment Outcome
Italy
Dual antiplatelet therapy
Conventional PCI
High bleeding risk
Cardiology and Cardiovascular Medicine
business
Immunosuppressive Agents
Platelet Aggregation Inhibitors
medicine.drug
Follow-Up Studies
Zdroj: International journal of cardiology. 290
ISSN: 1874-1754
Popis: Background This study aimed to evaluate real-world clinical outcome of patients needing short dual antiplatelet therapy (S-DAPT) following PCI with Ultimaster® thin-strut, biodegradable polymer sirolimus-eluting stent (BP-SES), which was supposed to induce faster stent endothelialization and reduce device thrombogenicity. Methods In this sub-group analysis of patients enrolled in the ULISSE registry, two groups were identified: 1) patients discharged with S-DAPT (≤3-month) due to high bleeding risk or need for urgent major non-cardiac surgery and 2) patients discharged with recommended DAPT (R-DAPT) duration (≥6-month). The primary ischemic-safety and bleeding-safety endpoints were TLF (composite of cardiac-death, target vessel MI, and clinically driven target lesion revascularization), and BARC major bleedings (≥type-3a) at 1-year follow-up. To account for events occurring before DAPT discontinuation we performed 3-month landmark analysis. Results 82 patients (5%) were discharged with ≤3-month DAPT (57 ± 27 days), and 1558 patients (94%) were discharged with ≥6-month DAPT (318 ± 75 days). No significant differences between S-DAPT and R-DAPT group were observed in TLF at 1-year (7.9% vs. 4.6%). The rate of BARC major bleeding resulted significantly higher in S-DAPT group (3.9% vs. 0.3%; p = 0.001), with the majority of bleeding events occurring within 3 months. The landmark analysis showed no significant differences in BARC major bleedings between groups (1.4% vs. 0.3%; p = 0.142). Conclusions As compared to those treated with R-DAPT (≥6-month), patients needing -S-DAPT (≤3-month) after PCI with Ultimaster® BP-SES had similar rates of 1-year TLF and BARC major bleedings following early DAPT discontinuation.
Databáze: OpenAIRE
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