Abstract:
BACKGROUND:After primary percutaneous coronary intervention (PPCI) in patients with acute ST elevation myocardial infarction (STEMI), dual antiplatelet therapy (DAPT) is recommended to continue for 1 year. Occasionally, DAPT interruption may be required due to bleeding issues or unplanned surgical procedures. OBJECTIVE:To systematically evaluate the incidence of DAPT interruption within 1 year after PPCI. METHODS AND RESULTS:This was a single-centre, retrospective registry study. Consecutive patients with STEMI who underwent PPCI from 2013 to 2017 (N=538) were recruited into the analysis. The primary outcome was the incidence of interruption of DAPT within 1 year from the index PPCI. Secondary outcomes included incidence of bleeding in 1 year and prevalence of high bleeding risk (HBR) criteria at index presentation. Within 1 year, 17.1% (84/490) of post-PPCI survivors needed DAPT interruption and 7.1% (35/490) had major bleeding (Bleeding Academic Research Consortium type 3 or 5). At index presentation, HBR criteria were present in 36.1% (194/538) of patients. On univariate analysis, age, female gender, anaemia, anticoagulation, diabetes, hypertension and being a non-smoker were associated with DAPT interruption. On multivariate analysis, age was the only independent factor to predict DAPT interruption. CONCLUSION:DAPT interruption was not uncommon after PPCI in patients with STEMI particularly in the elderly. This has implication on stent selection during PPCI, and further studies are required to investigate which type of stent may best suit our real-life patients with STEMI.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Tam CC,Lee J,Chan KW,Lam CC,Wong YT,Chan E,Sze M,Lam YM,Chan C,Tse HF,Siu CWdoi
10.1136/postgradmedj-2019-136760subject
Has Abstractpub_date
2020-01-01 00:00:00pages
9-13issue
1131eissn
0032-5473issn
1469-0756pii
postgradmedj-2019-136760journal_volume
96pub_type
杂志文章abstract::Venepuncture is commonly regarded as a trivial procedure allocated to the most junior medical staff. The result of this policy is that junior doctors are required to perform a minimally invasive procedure on consenting patients without any structured venepuncture training or assessment. Consequently, inexperienced doc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
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journal_title:Postgraduate medical journal
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abstract::Focused assessment with sonography in trauma (FAST) is a limited ultrasound scan performed in the emergency department to assess patients admitted with blunt abdominal trauma (BAT). It is normally undertaken by emergency physicians in order to identify the presence of free fluid, which may represent haemoperitoneum. T...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.818.934
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journal_title:Postgraduate medical journal
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pub_type: 历史文章,杂志文章,评审
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
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journal_title:Postgraduate medical journal
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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