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Title: | Associations Between Dual Antiplatelet Therapy Score and Long-Term Mortality After Percutaneous Coronary Intervention: Analysis of More Than 27,000 Patients. |
Author: | Tan, M. Dinh, D. Gayed, D. Liang, D. Brennan, A. Duffy, S. Clark, D. Ajani, A. Oqueli, Ernesto Roberts, L. Reid, C. Freeman, M. Chandrasekhar, J. |
Institutional Author: | Melbourne Interventional Group |
Issue Date: | 2024 |
Publication Title: | Canadian Journal of Cardiology |
Volume: | 40 |
Issue: | 11 |
Start Page: | 2045 |
End Page: | 2053 |
Abstract: | Background The dual antiplatelet therapy (DAPT) score was developed to identify patients undergoing percutaneous coronary intervention (PCI) who are likely to derive benefit (score ≥ 2) or harm (score < 2) from extended DAPT beyond 1 year after PCI in terms of ischemic and bleeding outcomes. We examined the associations between DAPT score at index PCI and long-term mortality from an all-comers PCI registry in patients receiving DAPT according to the standard of care. Methods We retrospectively examined prospectively collected data from the Melbourne Interventional Group PCI database (2005-2018) and grouped patients as having DAPT score ≥ 2 or < 2. Long-term mortality was assessed from the Australian National Death Index linkage. The primary end point was long-term mortality as determined using survival analysis. Secondary end points included in-hospital events and 30-day major adverse cardiac events (MACE), a composite of death, myocardial infarction, or target vessel revascularisation. Results Of 27,740 study patients, 9402 (33.9%) had DAPT score ≥ 2. Patients with DAPT score ≥ 2 were younger, included more women, and had a higher prevalence of cardiovascular risk factors. Patients with DAPT score ≥ 2 had higher in-hospital mortality (3.0% vs 1.0%), major bleeding (2.3% vs 1.6%), 30-day MACE (7.1% vs 3.1%), and long-term mortality at a median follow-up of 5.17 years (21.9% vs 16.5%) P < 0.001 for all. Conclusions One-third of all-comer patients undergoing PCI had a DAPT score ≥ 2 with greater short-term ischemic and bleeding risk, and higher long-term mortality. Risk assessment with the DAPT score may guide the duration and intensity of DAPT beyond the early post-PCI period. |
URI: | http://hdl.handle.net/11054/2874 |
DOI: | https://doi.org/10.1016/j.cjca.2024.06.030 |
Internal ID Number: | 02900 |
Health Subject: | PERCUTANEOUS CORONARY INTERVENTION PCI CARDIOLOGY ANTIPLATELET THERAPY |
Type: | Journal Article Article |
Appears in Collections: | Research Output |
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