Left main or proximal left anterior descending coronary artery disease location identifies high-risk patients deriving potentially greater benefit from prolonged dual antiplatelet therapy duration

EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Francesco CostaMarco Valgimigli

Abstract

It is currently unclear if the location of coronary artery disease affects decision making with regard to dual antiplatelet therapy (DAPT). We investigated if the presence of at least 30% luminal narrowing in the left main (LM) and/or proximal left anterior descending (pLAD) coronary arteries on angiography is an outcome modifier with respect to DAPT duration. In the Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia (PRODIGY) study, 953 (54.3%) patients with and 801 (45.7%) without LM/pLAD lumen narrowing at the qualifying coronary intervention were randomised to six or 24 months of DAPT. Twenty-four month as compared to six-month DAPT reduced the occurrence of definite, probable or possible stent thrombosis by 50% in patients with (2.8% vs. 5.6%; HR 0.45, 95% CI: 0.23-0.89; p=0.02) but not in those without LM/pLAD lumen narrowing, with a highly significant interaction testing (PINT= 0.002). This result remained consistent irrespective of whether stenting was (PINT: 0.01) or was not (PINT: 0.02) performed in the LM/pLAD. Left main and/or proximal LAD lumen narrowing may be a treatment modifier with respect to the duration of DAPT. Patients fulfilling these angiographic characteristics seem t...Continue Reading

References

Mar 15, 2006·The New England Journal of Medicine·Deepak L BhattUNKNOWN CHARISMA Investigators
May 2, 2007·Circulation·Donald E CutlipUNKNOWN Academic Research Consortium
Jan 21, 2011·The New England Journal of Medicine·Gregg W StoneUNKNOWN PROSPECT Investigators
May 21, 2011·JACC. Cardiovascular Interventions·Donald E CutlipRenu Virmani
Mar 23, 2012·Circulation·Marco ValgimigliUNKNOWN Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia Study (PRODIGY) Investigators
Jun 7, 2014·Circulation Research·Hector M Garcia-GarciaZahi A Fayad
Aug 16, 2014·Journal of the American College of Cardiology·Jinwei TianIk-Kyung Jang
Nov 18, 2014·The New England Journal of Medicine·Laura MauriUNKNOWN DAPT Study Investigators
May 20, 2015·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Marco ValgimigliStephan Windecker

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Citations

May 13, 2020·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Pierre SabouretFrancesco Costa
May 31, 2020·Cardiovascular Drugs and Therapy·Despoina-Rafailia BenetouDimitrios Alexopoulos
Feb 13, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Michail I PapafaklisLampros K Michalis
Aug 31, 2017·Drugs·Francesco CostaMarco Valgimigli
Jun 6, 2018·European Heart Journal Supplements : Journal of the European Society of Cardiology·Michele Massimo GuliziaUNKNOWN Faculty for approval of the Consensus Document
Dec 8, 2020·Circulation Journal : Official Journal of the Japanese Circulation Society·Jungho ChoiYangsoo Jang
Oct 11, 2020·Cardiology Clinics·Francesco CostaLuigi Fimiani

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