Abstract 13206: Impact of Substantial 5-Year Dual Antiplatelet Therapy After Sirolimus-Eluting Stents Implantation
Purpose: The potential benefits and risks of the long term use of dual antiplatelet therapy (DAPT) in patients receiving drug-eluting stents have not been fully evaluated. Therefore, we retrospectively investigated the clinical outcomes after sirolimus-eluting stents (SES) implantation with 5-year substantial DAPT, compared to without 5-year substantial DAPT.
Methods: Between August 2004 and March 2005, consecutive 249 patients underwent percutaneous coronary intervention with SES at our institution. Clinical follow-up and antiplatelet regimen were retrospectively evaluated at 8 months and 5 years. After excluding 11 patients without DAPT at 8 months and 10 patients without 5-year antiplatelet regimen, 228 patients were divided into the 2 groups based on the antiplatelet treatment at 5 years (DAPT, n = 155, non-DAPT, n = 73).
Results: Five-year clinical follow-up was available in all patients. Patient characteristics and procedural characteristics were matched except for the incidences of diabetes (39.4% vs. 17.8%, p = 0.001) and hyperlipidemia (75.5% vs. 57.5%, p = 0.008). At 5 years, there were no significant differences in the incidences of death, myocardial infarction and stent thrombosis (Figure). Fatal bleedings was not occurred in the DAPT group and 6 fetal bleeding were occurred in the non-DAPT group (0% vs. 8.2%, p < 0.001).
Conclusions: The substantial 5-year use of DAPT after SES implantation might be not significantly more effective than non 5-year substantial DAPT in reducing the rate of death or myocardial infarction or stent thrombosis, without increasing the risk of fatal bleeding. These findings should be confirmed through randomized clinical trials.
- © 2011 by American Heart Association, Inc.