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Valgimigli, Marco; Campo, Gianluca; Monti, Monia; Vranckx, Pascal; Percoco, Gianfranco; Tumscitz, Carlo; Castriota, Fausto; Colombo, Federico; Tebaldi, Matteo; Fucà, Giuseppe; Kubbajeh, Moh'd; Cangiano, Elisa; Minarelli, Monica; Scalone, Antonella; Cavazza, Caterina; Frangione, Alice; Borghesi, Marco; Marchesini, Jlenia; Parrinello, Giovanni; Ferrari, Roberto

Short- Versus Long-Term Duration of Dual-Antiplatelet Therapy After Coronary Stenting : A Randomized Multicenter Trial : A Randomized Multicenter Trial

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  • Medientyp: E-Artikel
  • Titel: Short- Versus Long-Term Duration of Dual-Antiplatelet Therapy After Coronary Stenting : A Randomized Multicenter Trial : A Randomized Multicenter Trial
  • Beteiligte: Valgimigli, Marco; Campo, Gianluca; Monti, Monia; Vranckx, Pascal; Percoco, Gianfranco; Tumscitz, Carlo; Castriota, Fausto; Colombo, Federico; Tebaldi, Matteo; Fucà, Giuseppe; Kubbajeh, Moh'd; Cangiano, Elisa; Minarelli, Monica; Scalone, Antonella; Cavazza, Caterina; Frangione, Alice; Borghesi, Marco; Marchesini, Jlenia; Parrinello, Giovanni; Ferrari, Roberto
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2012
  • Erschienen in: Circulation
  • Sprache: Englisch
  • DOI: 10.1161/circulationaha.111.071589
  • ISSN: 1524-4539; 0009-7322
  • Schlagwörter: Physiology (medical) ; Cardiology and Cardiovascular Medicine
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec> <jats:title>Background—</jats:title> <jats:p>The optimal duration of dual-antiplatelet therapy and the risk-benefit ratio for long-term dual-antiplatelet therapy after coronary stenting remain poorly defined. We evaluated the impact of up to 6 versus 24 months of dual-antiplatelet therapy in a broad all-comers patient population receiving a balanced proportion of Food and Drug Administration–approved drug-eluting or bare-metal stents.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results—</jats:title> <jats:p> We randomly assigned 2013 patients to receive bare-metal, zotarolimus-eluting, paclitaxel-eluting, or everolimus-eluting stent implantation. At 30 days, patients in each stent group were randomly allocated to receive up to 6 or 24 months of clopidogrel therapy in addition to aspirin. The primary end point was a composite of death of any cause, myocardial infarction, or cerebrovascular accident. The cumulative risk of the primary outcome at 2 years was 10.1% with 24-month dual-antiplatelet therapy compared with 10.0% with 6-month dual-antiplatelet therapy (hazard ratio, 0.98; 95% confidence interval, 0.74–1.29; <jats:italic>P</jats:italic> =0.91). The individual risks of death, myocardial infarction, cerebrovascular accident, or stent thrombosis did not differ between the study groups; however, there was a consistently greater risk of hemorrhage in the 24-month clopidogrel group according to all prespecified bleeding definitions, including the recently proposed Bleeding Academic Research Consortium classification. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>A regimen of 24 months of clopidogrel therapy in patients who had received a balanced mixture of drug-eluting or bare-metal stents was not significantly more effective than a 6-month clopidogrel regimen in reducing the composite of death due to any cause, myocardial infarction, or cerebrovascular accident.</jats:p> </jats:sec> <jats:sec> <jats:title>Clinical Trial Registration—</jats:title> <jats:p> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: NCT00611286. </jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang