Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/26523
Title: | Left main or proximal left anterior descending coronary artery disease location identifies high-risk patients deriving potentially greater benefit from prolonged dual antiplatelet therapy duration | Authors: | Costa, Francesco Adamo, Marianna Ariotti, Sara Ferrante, Giuseppe Navarese, Eliano Pio Leonardi, Sergio Garcia-Garcia, Hector VRANCKX, Pascal Valgimigli, Marco |
Issue Date: | 2016 | Source: | EUROINTERVENTION, 11(11), p. E1222-E1230 | Abstract: | AIMS: It is currently unclear if the location of coronary artery disease affects decision making with regard to dual antiplatelet therapy (DAPT). We investigated if the presence of at least 30% luminal narrowing in the left main (LM) and/or proximal left anterior descending (pLAD) coronary arteries on angiography is an outcome modifier with respect to DAPT duration. METHODS AND RESULTS: In the Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia (PRODIGY) study, 953 (54.3%) patients with and 801 (45.7%) without LM/pLAD lumen narrowing at the qualifying coronary intervention were randomised to six or 24 months of DAPT. Twenty-four month as compared to six-month DAPT reduced the occurrence of definite, probable or possible stent thrombosis by 50% in patients with (2.8% vs. 5.6%; HR 0.45, 95% CI: 0.23-0.89; p=0.02) but not in those without LM/pLAD lumen narrowing, with a highly significant interaction testing (P-INT= 0.002). This result remained consistent irrespective of whether stenting was (P-INT: 0.01) or was not (P-INT: 0.02) performed in the LM/pLAD. CONCLUSIONS: Left main and/or proximal LAD lumen narrowing may be a treatment modifier with respect to the duration of DAPT. Patients fulfilling these angiographic characteristics seem to benefit from a prolonged dual antiplatelet treatment. | Keywords: | acute coronary syndrome; clopidogrel; dual antiplatelet therapy (DAPT); left main coronary artery; proximal left anterior descending coronary artery; stent thrombosis | Document URI: | http://hdl.handle.net/1942/26523 | ISSN: | 1774-024X | e-ISSN: | 1969-6213 | DOI: | 10.4244/EIJY15M08_04 | ISI #: | 000400774200006 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
Left_main_or_proximal_left_anterior_desc.pdf Restricted Access | Published version | 1.13 MB | Adobe PDF | View/Open Request a copy |
SCOPUSTM
Citations
20
checked on Sep 2, 2020
WEB OF SCIENCETM
Citations
30
checked on Jul 26, 2024
Page view(s)
62
checked on Sep 7, 2022
Download(s)
50
checked on Sep 7, 2022
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.