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- Title
Long-term outcomes following drug-eluting balloon or thin-strut drug-eluting stents for treatment of in-stent restenosis stratified by duration of dual antiplatelet therapy (DEB-Dragon Registry).
- Authors
Januszek, Rafał; Bil, Jacek; Gilis-Malinowska, Natasza; Staszczak, Bartłomiej; Figatowski, Tomasz; Milewski, Marek; Mielczarek, Maksymilian; Dylewski, Łukasz; Wybraniec, Maciej; Tomasiewicz, Brunon; Kübler, Piotr; Walczak, Tomasz; Hrymniak, Bruno; Desperak, Piotr; Niezgoda, Piotr; Wolny, Rafał; Chudzik, Magdalena; Smolka, Grzegorz; Ciećwierz, Dariusz; Reczuch, Krzysztof
- Abstract
Introduction: Data regarding the duration of dual antiplatelet therapy (DAPT) in patients with drug-eluting stent restenosis (DES-ISR) treated with percutaneous coronary intervention (PCI) and drug-eluting balloons (DEB) or DES are not unambiguous. Aim: To evaluate the relationship between long-term outcomes and the length of DAPT in patients treated with PCI due to DES-ISR with DEB or DES. Material and methods: Overall, a total of 1,367 consecutive patients with DES-ISR, who underwent PCI with DEB or DES between 2008 and 2019 entered the study. The mean length of the follow-up was 1,298.7 ±794 days. We assessed study endpoints according to the duration of DAPT (≤ 3 vs. > 3 and ≤ 6 vs. > 6 months) before and after propensity score matching (PSM): stroke, target lesion revascularisation (TLR), target vessel revascularisation (TVR), myocardial infarction (MI), death and device oriented composite endpoints (DOCE). Kaplan-Meier estimates were created to differentiate long-term outcomes. Results: Pairwise contrast analysis considering type of PCI (DES vs. DEB) and duration of DAPT (≤ 6 vs. > 6 months) before PSM revealed superiority of DES + DAPT > 6 months vs. DEB + DAPT > 6 months for DOCE (p < 0.001), TVR (p = 0.02) and TLR (p = 0.01). Also, DES + DAPT ≤ 6 months was found to be superior compared to DEB + DAPT ≤ 6 months for DOCE (p < 0.001), TVR (p = 0.02) and TLR (p = 0.01). Kaplan-Meier estimate analysis confirmed that DAPT > 6 months is related to a higher stroke rate (p = 0.01) when compared to ≤ 6 months. Conclusions: Treatment with DAPT in patients with DES-ISR is related to better long-term outcomes in the case of PCI with DES than DEB. DAPT > 6 months is related to the greater rate of strokes, independently of the type of treatment (DES and DEB) than DAPT ≤ 6 months.
- Subjects
DRUG-eluting stents; PLATELET aggregation inhibitors; PERCUTANEOUS coronary intervention; PROPENSITY score matching; MYOCARDIAL infarction
- Publication
Advances in Interventional Cardiology / Postępy w Kardiologii Interwencyjnej, 2022, Vol 18, Issue 1, p14
- ISSN
1734-9338
- Publication type
Article
- DOI
10.5114/aic.2022.115631