Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/2874
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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