Benefit-Risk Profile of DAPT Continuation Beyond 1 Year after PCI in Patients with High Thrombotic Risk Features as Endorsed by 2018 ESC/EACTS Myocardial Revascularization Guideline.

Abstract:

PURPOSE:The ischemic/bleeding trade-off of continuing dual antiplatelet therapy (DAPT) beyond 1 year after PCI for patients with high thrombotic risk (HTR) as endorsed by 2018 ESC/EACTS myocardial revascularization guidelines remain unknown. METHODS:Patients undergoing coronary stenting between January 2013 and December 2013 from the prospective Fuwai registry were defined as HTR if they met at least 1 ESC/EACTS guideline-endorsed HTR criteria. A total of 4578 patients who were at HTR and were events free at 1 year after the index procedure were evaluated. The primary efficacy outcome was major adverse cardiac and cerebrovascular events (MACCE) (composite of all-cause death, myocardial infarction, or stroke). RESULTS:Median follow-up period was 2.4 years. > 1-year DAPT with clopidogrel and aspirin significantly reduced the risk of MACCE compared with ≤ 1-year DAPT (1.9% vs. 4.6%; hazard ratio (HR): 0.38; 95% confidence interval (CI): 0.27-0.54; P < 0.001), driven by a reduction in all-cause death (0.2% vs. 3.0%; HR, 0.07; 95% CI, 0.03-0.15). Cardiac death and definite/probable stent thrombosis also occurred less frequently in prolonged DAPT group. Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding occurred similarly between both groups (1.1% vs. 0.9%; HR, 1.11; 95% CI, 0.58-2.13; P = 0.763). Similar results were found using multivariable Cox model, propensity score-matched, and inverse probability of treatment weighting analysis. CONCLUSIONS:Among patients with ESC-endorsed HTR who were free from major ischemic or bleeding events 1 year after coronary stenting, continued DAPT beyond 1 year might offer better effectiveness in terms of atherothrombotic events and comparable safety in terms of clinically relevant bleeding compared with ≤ 1-year DAPT. ESC-HTR criteria is an important parameter to take into account in tailoring DAPT prolongation.

journal_name

Cardiovasc Drugs Ther

authors

Wang HY,Dou KF,Wang Y,Yin D,Xu B,Gao RL

doi

10.1007/s10557-020-07030-9

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

663-675

issue

5

eissn

0920-3206

issn

1573-7241

pii

10.1007/s10557-020-07030-9

journal_volume

34

pub_type

杂志文章
  • Influence of antihypertensive therapy with cilazapril and hydrochlorothiazide on the stiffness of the aorta.

    abstract::The purpose of this study was to examine the effects of the angiotensin-converting enzyme (ACE) inhibitor cilazapril on the elastic properties of the aorta. A standard diuretic antihypertensive drug, hydrochlorothiazide, served for comparisons. Increased aortic stiffness leads to a reduction of the buffering windkesse...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/BF00051130

    authors: Breithaupt-Grögler K,Leschinger M,Belz GG,Butzer R,Erb K,de May C,Sinn W

    更新日期:1996-03-01 00:00:00

  • Vascular complications in hypertension: the VHAS study. Verapamil-Hypertension Atherosclerosis Study.

    abstract::The VHAS (Verapamil-Hypertension Atherosclerosis Study) Investigators entered 1464 patients with essential hypertension and blood pressure (BP) values > or = 160 mmHg systolic and 95 mmHg diastolic (DBP) but excluded those with a DBP > or = 115 mmHg, and those with diabetes mellitus or previous myocardial infarction o...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1007/BF00877865

    authors: Zanchetti A

    更新日期:1995-08-01 00:00:00

  • Encainide.

    abstract::Encainide is a class IC antiarrhythmic agent having little or no effect on action-potential duration or maximum diastolic potential but decreasing the maximum rate of phase O depolarization as well as increasing atrial and ventricular effective refractory periods. In intact animals or humans, encainide increases the A...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章,评审

    doi:10.1007/BF01857621

    authors: Antonaccio MJ,Gomoll AW,Byrne JE

    更新日期:1989-10-01 00:00:00

  • The Association of Low Molecular Weight Heparin Use and In-hospital Mortality Among Patients Hospitalized with COVID-19.

    abstract:PURPOSE:To determine the association between low molecular weight heparin (LMWH) use and mortality in hospitalized COVID-19 patients. METHODS:We conducted a retrospective study of patients consecutively enrolled from two major academic hospitals exclusively for COVID-19 in Wuhan, China, from January 26, 2020, to March...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1007/s10557-020-07133-3

    authors: Shen L,Qiu L,Liu D,Wang L,Huang H,Ge H,Xiao Y,Liu Y,Jin J,Liu X,Wang DW,Peterson ED,He B,Zhou N

    更新日期:2021-01-04 00:00:00

  • Effect of an educational program (PEGASE) on cardiovascular risk in hypercholesterolaemic patients.

    abstract:BACKGROUND:Many studies have demonstrated a gap between guidelines for the prevention of cardiovascular disease (CVD) and their implementation in clinical practice. AIM:The PEGASE education program has been devised with an aim to improve the management of patients at high risk of CVD. METHODS:In a multicentre study c...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s10557-008-6137-4

    authors: Bruckert E,Giral P,Paillard F,Ferrières J,Schlienger JL,Renucci JF,Abdennbi K,Durack I,Chadarevian R,PEGASE group.

    更新日期:2008-12-01 00:00:00

  • Cardiac resynchronization therapy in patients with mild heart failure: a systematic review and meta-analysis of randomized controlled trials.

    abstract:OBJECTIVE:This review aims at updating the results of cardiac resynchronization therapy (CRT) in mild heart failure patients, and investigating whether CRT can prevent or reverse heart failure progression in an earlier stage. METHODS:Randomized controlled trials of CRT in patients with New York Heart Association (NYHA...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章,meta分析,评审

    doi:10.1007/s10557-011-6313-9

    authors: Tu R,Zhong G,Zeng Z,Wu W,Wu H,Cao X,Aung LH

    更新日期:2011-08-01 00:00:00

  • Use of milrinone in cardiac surgical patients.

    abstract::Milrinone is shown in 10 patients to be a valuable pharmacological bridge to heart transplantation; it can stabilize and improve decompensated chronic heart failure (CHF) in cases where the response to beta-agonists is inadequate. One patient who had suffered an acute myocardial infarction with heart failure resistant...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章,评审

    doi:10.1007/BF00877820

    authors: Sherry KM,Locke TJ

    更新日期:1993-08-01 00:00:00

  • Comparative study of time-course of hemodynamic effect of isosorbide dinitrate spray and sublingual tablets in patients with pulmonary congestion.

    abstract::We compared the time-course of the hemodynamic effect of isosorbide dinitrate (ISDN), 5 mg, in the form of sublingual tablet and oral spray, in 15 patients with isolated chronic pulmonary congestion (pulmonary arterial end-diastolic pressure of 15 mmHg or more in the presence of normal or only slightly reduced cardiac...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1007/BF00051192

    authors: Marchionni N,De Bari M,Ferrucci L,Moschi G,Schneeweiss A

    更新日期:1988-11-01 00:00:00

  • Renal effects of calcium entry blockers.

    abstract::Calcium entry blockers exert several characteristic effects on renal function that contribute to their blood-pressure lowering capacity. They are able to dilate renal vasculature and, in certain circumstances, can increase the glomerular filtration rate, both effects being dependent on the preexisting vascular tone. C...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章,评审

    doi:10.1007/BF02018304

    authors: Ruilope LM,Alcazar JM

    更新日期:1990-08-01 00:00:00

  • Protective effects of hydrogen sulfide against chronic alcohol intake-induced left ventricular remodeling in rats.

    abstract:PURPOSE:To investigate the protective effects of hydrogen sulfide (H(2)S) against chronic alcohol intake-induced left ventricular remodeling and explore the potential mechanisms involved. METHODS:Rats were randomly divided into 4 groups: alcohol group, NaHS group, alcohol + NaHS group, and control group. The echocardi...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1007/s10557-013-6441-5

    authors: Zhou X,Lu X,Xu W,Chen J

    更新日期:2013-06-01 00:00:00

  • OPC-8212 in the treatment of congestive heart failure: results of a pilot study.

    abstract::To characterize the effects of OPC-8212, a quinolone inotropic agent, in patients with heart failure, we utilized invasive hemodynamics, exercise testing, 24-hour ambulatory electrocardiograms, and two patient self-assessment questionnaires, before and after 1 month of treatment with OPC-8212, in 17 patients with mode...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1007/BF00054205

    authors: Kubo SH,Rector TS,Strobeck JE,Cohn JN

    更新日期:1988-12-01 00:00:00

  • Attenuation of KATP channel-opener induced shortening of repolarization time by alpha 1-adrenoceptor antagonist during ischemia in canine heart.

    abstract::The purpose of the study was to determine whether a new KATP channel opener, Y 26763 (Y), can influence the electrophysiological properties in the ischemic myocardium as well as to determine whether the blunting effect of the alpha 1-adrenoceptor antagonist bunazosin (BN) on an ischemia-induced shortening of repolariz...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1023/a:1007830607733

    authors: Tanabe T,Aikawa M,Deguchi Y,Yoshioka K,Handa S

    更新日期:2000-06-01 00:00:00

  • Torsades de pointes: prevention and therapy.

    abstract::Torsades de pointes (TdP) is a life-threatening ventricular tachycardia that occurs in the setting of a prolonged QT interval and is most frequently related to administration of antiarrhythmic drugs. Patients with organic heart disease, with low serum electrolyte levels, with a previous episode of TdP and with bradyca...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章,评审

    doi:10.1007/BF03029778

    authors: Keren A,Tzivoni D

    更新日期:1991-04-01 00:00:00

  • Azelnidipine inhibits H2O2-induced cell death in neonatal rat cardiomyocytes.

    abstract:PURPOSE:Oxidative stress plays an important role in the pathogenesis of cardiovascular diseases. Azelnidipine is a novel dihydropyridine calcium channel blocker. Several studies have demonstrated that some dihydropyridine calcium channel blockers have antioxidant effects. We evaluated the antioxidant effects of azelnid...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1007/s10557-007-6008-4

    authors: Koyama Y,Takeishi Y,Takahashi H,Shishido T,Arimoto T,Niizeki T,Harada M,Suzuki S,Kitahara T,Sasaki T,Kubota I

    更新日期:2007-02-01 00:00:00

  • Comparison of captopril with enalapril in the treatment of heart failure: influence on hemodynamics and measures of renal function.

    abstract::Twenty-nine patients with severe heart failure (NYHA III) were randomly assigned to receive therapy with an angiotensin converting enzyme inhibitor (ACE inhibitor), either captopril or enalapril. The mean daily dosage of captopril was 56 +/- 5 mg and of enalapril 9.5 +/- 0.4 mg. After a mean of 8 +/- 1 days, the influ...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/BF00054567

    authors: Osterziel KJ,Dietz R,Harder K,Kübler W

    更新日期:1992-04-01 00:00:00

  • Verapamil and diet halt progression of atherosclerosis in cholesterol fed rabbits.

    abstract::The present study was designed to evaluate the effects of oral verapamil and normal diet on regression of atherosclerotic plaque in cholesterol fed rabbits. Forty-three rabbits were separated into 6 groups and studied for 24 weeks. All groups had a cholesterol diet for the first 12 weeks. Group I was then sacrificed a...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1007/BF02125835

    authors: Sievers RE,Rashid T,Garrett J,Blumlein S,Parmley WW

    更新日期:1987-01-01 00:00:00

  • Amiodarone concentration in human myocardium after rapid intravenous administration.

    abstract::Intravenous amiodarone has been found useful in the emergent management of life-threatening arrhythmias. Experimental studies have shown that its electrophysiologic effects are proportional to its myocardial concentration. However, early after its intravenous administration, the extent of the concentration of amiodaro...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1023/a:1007756411790

    authors: Anastasiou-Nana MI,Nanas JN,Alexopoulos G,Karli JN,Margari ZJ,Agapitos E,Patsi EN,Stamatelopoulos SF

    更新日期:1999-05-01 00:00:00

  • Cholesterol confusion in primary prevention of coronary artery disease.

    abstract::Despite the impressive relation between an increased blood cholesterol and increased mortality from coronary artery disease and despite the persuasive results of cholesterol-lowering trials in secondary prevention, there are increasing reservations about the wisdom of lowering moderately raised blood cholesterol level...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 社论

    doi:10.1007/BF00878930

    authors: Opie LH

    更新日期:1993-11-01 00:00:00

  • Ibopamine versus hydrochlorothiazide/amiloride in patients with mild congestive heart failure. SK & F Ibopamine Working Group.

    abstract::The clinical efficacy and safety of ibopamine and diuretic therapy were compared in a multicenter, multinational, parallel, positive-controlled, randomized, double-blind, 12-week study, involving 103 patients with mild CHF (NYHA Class II). Body weight, NYHA functional class, symptom assessment scores, laboratory blood...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1007/BF01869579

    authors:

    更新日期:1989-12-01 00:00:00

  • Effect of flecainide on heart rate variability in subjects without coronary artery disease or congestive heart failure.

    abstract::Heart rate variability is a noninvasive indicator of autonomic nervous system activity. The role of the autonomic nervous system in the genesis of atrial or ventricular arrhythmias is now well established. Little is known about the effects of flecainide on heart rate variability in patients with normal heart structure...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1023/a:1007710301259

    authors: Fauchier L,Babuty D,Autret ML,Poret P,Cosnay P,Fauchier JP

    更新日期:1998-10-01 00:00:00

  • Effect of trimetazidine on late potentials after acute myocardial infarction.

    abstract::The purpose of this study was to evaluate the effect of trimetazidine on late potentials in patients with acute myocardial infarction. A total of 60 patients (52 males, mean age 55 +/- 2 years, and 8 females, mean age 54 +/- 1.8 years) with the diagnosis of acute myocardial infarction were included in this study. The ...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1023/a:1007740311072

    authors: Ozdemir R,Tuncer C,Aladag M,Güven A,Sezgin AT,Pekdemir H,Korkmaz ME,Müderrisoglu H

    更新日期:1999-04-01 00:00:00

  • Accelerated myocardial metabolic and functional recovery with terminal nicorandil-Mg cardioplegia in heart transplantation.

    abstract::Cardiac reperfusion injury after heart transplantation or cardiopulmonary bypass has been difficult to control due to the variable degree of myocardial damage with respect to the length of ischemia and the complexity of the surgical procedure. Here, we evaluated the myocardial metabolic and functional recovery of hear...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1007/BF03029747

    authors: Orita H,Shimanuki T,Fukasawa M,Abe H,Kuraoka S,Hirooka S,Washio M

    更新日期:1991-08-01 00:00:00

  • Bradycardia induced by mivazerol, a selective alpha 2-adrenoceptor agonist, is amplified during mild hypothermia in the pentobarbital-anesthetized rat.

    abstract::Mivazerol, 3-[1(H-imidazol-4-yl)methyl]-2-hydroxybenzamide hydrochloride, is a selective alpha 2-adrenoceptor agonist designed for the prevention of myocardial infarction in perioperative patients. Because unintended hypothermia occurs frequently during surgery, we were interested, in this study, to examine the relati...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1023/a:1007762107360

    authors: Kim SY,Raikoff K,Wülfert E,Hanin I

    更新日期:1997-12-01 00:00:00

  • Functional antagonism of different angiotensin II type I receptor blockers in human arteries.

    abstract:OBJECTIVES:To evaluate and compare the functional type and the degree of antagonism of the selective angiotensin II type 1 receptor blockers (ARB) losartan, EXP 3174 (the active metabolite of losartan), valsartan and candesartan in human internal mammary arteries. METHODS:Human internal mammary arteries were obtained ...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1023/a:1021729909456

    authors: Wagenaar LJ,Voors AA,Buikema H,van Buiten A,Lübeck RH,Boonstra PW,van Veldhuisen DJ,van Gilst WH

    更新日期:2002-07-01 00:00:00

  • TAK1-AMPK Pathway in Macrophages Regulates Hypothyroid Atherosclerosis.

    abstract:PURPOSE:Hypothyroidism (HT) is associated with accelerated atherosclerosis (AS). The efficacy of traditional strategies of hypothyroid AS remains controversial. Here, we aimed to deepen the understanding of the HT-induced acceleration of AS, to decrease the residual risk of coronary artery disease (CAD) and to find a n...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1007/s10557-020-06996-w

    authors: Yang Y,Jia Y,Ning Y,Wen W,Qin Y,Zhang H,Du Y,Li L,Jiao X,Yang Y,Liu G,Huang M,Zhang M

    更新日期:2020-06-03 00:00:00

  • Diabetic cardiomyopathy.

    abstract::Diabetic cardiomyopathy as a distinct entity was first recognized by Rubler et al. in diabetics with congestive heart failure (CHF), who had no evidence of coronary atherosclerosis. The Framingham study showed a 2.4-fold increased incidence of CHF in diabetic men and a 5.1-fold increase in diabetic women over 18 years...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章,评审

    doi:10.1007/BF00877091

    authors: Fein FS,Sonnenblick EH

    更新日期:1994-02-01 00:00:00

  • Safety, tolerability, and neurohormonal changes of the combination captopril plus losartan in the early postinfarction period: a pilot study.

    abstract::Suppression of formation of angiotensin II (A-II) is thought to be a major contributor to the hemodynamic response to angiotensin-converting enzyme inhibition (ACE-in) therapy. However, angiotensin II (A-II) plasma levels may rebound during ACE-in treatment. The study sought to verify the feasibility, safety, and tole...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1023/a:1007739412802

    authors: Di Pasquale P,Bucca V,Scalzo S,Paterna S

    更新日期:1998-05-01 00:00:00

  • Myocardial ischemia and reperfusion: the role of oxygen radicals in tissue injury.

    abstract::Thrombolytic therapy has gained widespread acceptance as a means of treating coronary artery thrombosis in patients with acute myocardial infarction. Although experimental data have demonstrated that timely reperfusion limits the extent of infarction caused by regional ischemia, there is growing evidence that reperfus...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章,评审

    doi:10.1007/BF00133206

    authors: Werns SW,Lucchesi BR

    更新日期:1989-01-01 00:00:00

  • KT-362 related effects on intracellular calcium release and associated clinical potential: arrhythmias, myocardial ischemia, and hypertension.

    abstract::The following discourse addresses the pharmacologic profile of KT-362, its clinical potential as an anti-arrhythmic agent with associated hypotensive effects, as well as its additional related potential in myocardial ischemia and related sequellae, and the specific cellular actions that may be responsible for these po...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章,评审

    doi:10.1007/BF02018262

    authors: Hester RK,Shibata S

    更新日期:1990-10-01 00:00:00

  • Recombinant human interleukin-1 receptor antagonist provides cardioprotection during myocardial ischemia reperfusion in the mouse.

    abstract:PURPOSE:Acute myocardial infarction (AMI) drives an intense inflammatory response that contributes to infarct healing and cardiac remodeling. Recently, different studies have identified a role of interleukin-1 (IL-1) in the development of adverse cardiac remodeling. However, in animal models of AMI IL-1 has been shown ...

    journal_title:Cardiovascular drugs and therapy

    pub_type: 杂志文章

    doi:10.1007/s10557-012-6389-x

    authors: Toldo S,Schatz AM,Mezzaroma E,Chawla R,Stallard TW,Stallard WC,Jahangiri A,Van Tassell BW,Abbate A

    更新日期:2012-06-01 00:00:00