Trends in antithrombotic therapy and clinical outcomes for percutaneous coronary intervention in Japan following the 2020 JCS guideline focused update: findings from the SAKURA PCI2 Antithrombotic Registry.

IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Heart and Vessels Pub Date : 2024-12-06 DOI:10.1007/s00380-024-02493-4
Riku Arai, Nobuhiro Murata, Keisuke Kojima, Michiaki Matsumoto, Naoya Matsumoto, Tomoyuki Morikawa, Wataru Atsumi, Eizo Tachibana, Hironori Haruta, Takaaki Kogo, Yasunari Ebuchi, Kazumiki Nomoto, Masaru Arai, Ken Arima, Takashi Mineki, Yutaka Koyama, Koji Oiwa, Yasuo Okumura
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引用次数: 0

Abstract

In April 2020, the Japanese Circulation Society updated guidelines recommending shortened dual antiplatelet therapy (DAPT) for patients at Japanese Version of the High Bleeding Risk (J-HBR), but the impact remains unclear. We conducted a prospective multicenter registry (SAKURA PCI2 Antithrombotic Registry) starting June 2020 (n = 1136), enrolling patients who underwent percutaneous coronary intervention (PCI). Planned DAPT duration, defined as short if less than 3 months, was based on patient background post-PCI and physicians' discretion. Planned short DAPT was used in 55.2% of patients, with a similar incidence of J-HBR (68.3% vs. 66.6%, p = 0.55) and a shorter actual DAPT duration (97 vs. 229 days, p < 0.001) compared with Planned non-short DAPT. Primary endpoints, major adverse cardiovascular and cerebrovascular events (MACCE) including all-cause death, non-fatal myocardial infarction, stent thrombosis, and stroke, and Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding (BARC-3/5), occurred similarly across groups (MACCE: 6.5% vs. 7.3%, p = 0.66; BARC-3/5: 3.7% vs. 2.2%, p = 0.14). Independent predictors of MACCE included age ≥ 75, Clinical Frailty Scale ≥ 4, and hemoglobin < 11. Age ≥ 75, severe chronic kidney disease, hemoglobin < 11, and platelets < 100,000 were linked to BARC-3/5. Among BARC 3/5 patients, 41.2% experienced bleeding after switching to single antiplatelet therapy. Planned short DAPT was implemented in 55.2% of patients, showing comparable thrombotic and bleeding outcomes to non-short DAPT.

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来源期刊
Heart and Vessels
Heart and Vessels 医学-外周血管病
CiteScore
3.10
自引率
13.30%
发文量
211
审稿时长
2 months
期刊介绍: Heart and Vessels is an English-language journal that provides a forum of original ideas, excellent methods, and fascinating techniques on cardiovascular disease fields. All papers submitted for publication are evaluated only with regard to scientific quality and relevance to the heart and vessels. Contributions from those engaged in practical medicine, as well as from those involved in basic research, are welcomed.
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