Optimal Strategy for Antiplatelet Therapy After Endovascular Revascularization for Lower Extremity Peripheral Artery Disease

The aim of this study was to investigate the optimal strategy for antiplatelet therapy in patients with lower extremity peripheral artery disease (PAD) after endovascular revascularization. The optimal strategy for antiplatelet therapy in patients with PAD after endovascular revascularization has no...

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Veröffentlicht in:JACC. Cardiovascular interventions 2019-12, Vol.12 (23), p.2359-2370
Hauptverfasser: Cho, Sungsoo, Lee, Yong-Joon, Ko, Young-Guk, Kang, Tae Soo, Lim, Seong-Hoon, Hong, Sung-Jin, Ahn, Chul-Min, Kim, Jung-Sun, Kim, Byeong-Keuk, Choi, Donghoon, Hong, Myeong-Ki, Jang, Yangsoo
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container_title JACC. Cardiovascular interventions
container_volume 12
creator Cho, Sungsoo
Lee, Yong-Joon
Ko, Young-Guk
Kang, Tae Soo
Lim, Seong-Hoon
Hong, Sung-Jin
Ahn, Chul-Min
Kim, Jung-Sun
Kim, Byeong-Keuk
Choi, Donghoon
Hong, Myeong-Ki
Jang, Yangsoo
description The aim of this study was to investigate the optimal strategy for antiplatelet therapy in patients with lower extremity peripheral artery disease (PAD) after endovascular revascularization. The optimal strategy for antiplatelet therapy in patients with PAD after endovascular revascularization has not been established. From March 2008 to February 2013, 693 patients with lower extremity PAD treated with different antiplatelet therapies, such as mono-antiplatelet therapy (MAPT) and dual-antiplatelet therapy (DAPT), of various durations after endovascular revascularization were analyzed. They were classified into 2 groups (DAPT 
doi_str_mv 10.1016/j.jcin.2019.08.006
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The optimal strategy for antiplatelet therapy in patients with PAD after endovascular revascularization has not been established. From March 2008 to February 2013, 693 patients with lower extremity PAD treated with different antiplatelet therapies, such as mono-antiplatelet therapy (MAPT) and dual-antiplatelet therapy (DAPT), of various durations after endovascular revascularization were analyzed. They were classified into 2 groups (DAPT &lt;6 months or MAPT vs. DAPT ≥6 months). The primary outcomes were major adverse cardiovascular events and major adverse limb events. The safety outcome was major bleeding. During 5-year follow-up, major adverse cardiovascular events occurred less frequently in the DAPT ≥6-month group than the DAPT &lt;6-month or MAPT group (17.3% vs. 31.3%; hazard ratio: 0.44; 95% confidence interval: 0.30 to 0.65; p &lt; 0.001). Major adverse limb events also occurred less frequently in the DAPT ≥6-month group than the DAPT &lt;6-month or MAPT group (21.5% vs. 43.7%; hazard ratio: 0.42; 95% CI: 0.30 to 0.58; p &lt; 0.001). However, major bleeding events were infrequent, with no signal toward harm with DAPT ≥6 months. Results were consistent after inverse probability-weighted adjustment and propensity score matching. Following endovascular revascularization for lower extremity PAD, DAPT ≥6 months was associated with decreased 5-year major adverse cardiovascular events and major adverse limb events. [Display omitted]</description><identifier>ISSN: 1936-8798</identifier><identifier>EISSN: 1876-7605</identifier><identifier>DOI: 10.1016/j.jcin.2019.08.006</identifier><language>eng</language><publisher>Elsevier Inc</publisher><subject>antiplatelet therapy ; endovascular revascularization ; peripheral artery disease</subject><ispartof>JACC. 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Cardiovascular interventions</title><description>The aim of this study was to investigate the optimal strategy for antiplatelet therapy in patients with lower extremity peripheral artery disease (PAD) after endovascular revascularization. The optimal strategy for antiplatelet therapy in patients with PAD after endovascular revascularization has not been established. From March 2008 to February 2013, 693 patients with lower extremity PAD treated with different antiplatelet therapies, such as mono-antiplatelet therapy (MAPT) and dual-antiplatelet therapy (DAPT), of various durations after endovascular revascularization were analyzed. They were classified into 2 groups (DAPT &lt;6 months or MAPT vs. DAPT ≥6 months). The primary outcomes were major adverse cardiovascular events and major adverse limb events. The safety outcome was major bleeding. During 5-year follow-up, major adverse cardiovascular events occurred less frequently in the DAPT ≥6-month group than the DAPT &lt;6-month or MAPT group (17.3% vs. 31.3%; hazard ratio: 0.44; 95% confidence interval: 0.30 to 0.65; p &lt; 0.001). Major adverse limb events also occurred less frequently in the DAPT ≥6-month group than the DAPT &lt;6-month or MAPT group (21.5% vs. 43.7%; hazard ratio: 0.42; 95% CI: 0.30 to 0.58; p &lt; 0.001). However, major bleeding events were infrequent, with no signal toward harm with DAPT ≥6 months. Results were consistent after inverse probability-weighted adjustment and propensity score matching. Following endovascular revascularization for lower extremity PAD, DAPT ≥6 months was associated with decreased 5-year major adverse cardiovascular events and major adverse limb events. 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Cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cho, Sungsoo</au><au>Lee, Yong-Joon</au><au>Ko, Young-Guk</au><au>Kang, Tae Soo</au><au>Lim, Seong-Hoon</au><au>Hong, Sung-Jin</au><au>Ahn, Chul-Min</au><au>Kim, Jung-Sun</au><au>Kim, Byeong-Keuk</au><au>Choi, Donghoon</au><au>Hong, Myeong-Ki</au><au>Jang, Yangsoo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal Strategy for Antiplatelet Therapy After Endovascular Revascularization for Lower Extremity Peripheral Artery Disease</atitle><jtitle>JACC. Cardiovascular interventions</jtitle><date>2019-12-09</date><risdate>2019</risdate><volume>12</volume><issue>23</issue><spage>2359</spage><epage>2370</epage><pages>2359-2370</pages><issn>1936-8798</issn><eissn>1876-7605</eissn><abstract>The aim of this study was to investigate the optimal strategy for antiplatelet therapy in patients with lower extremity peripheral artery disease (PAD) after endovascular revascularization. The optimal strategy for antiplatelet therapy in patients with PAD after endovascular revascularization has not been established. From March 2008 to February 2013, 693 patients with lower extremity PAD treated with different antiplatelet therapies, such as mono-antiplatelet therapy (MAPT) and dual-antiplatelet therapy (DAPT), of various durations after endovascular revascularization were analyzed. They were classified into 2 groups (DAPT &lt;6 months or MAPT vs. DAPT ≥6 months). The primary outcomes were major adverse cardiovascular events and major adverse limb events. The safety outcome was major bleeding. During 5-year follow-up, major adverse cardiovascular events occurred less frequently in the DAPT ≥6-month group than the DAPT &lt;6-month or MAPT group (17.3% vs. 31.3%; hazard ratio: 0.44; 95% confidence interval: 0.30 to 0.65; p &lt; 0.001). Major adverse limb events also occurred less frequently in the DAPT ≥6-month group than the DAPT &lt;6-month or MAPT group (21.5% vs. 43.7%; hazard ratio: 0.42; 95% CI: 0.30 to 0.58; p &lt; 0.001). However, major bleeding events were infrequent, with no signal toward harm with DAPT ≥6 months. Results were consistent after inverse probability-weighted adjustment and propensity score matching. Following endovascular revascularization for lower extremity PAD, DAPT ≥6 months was associated with decreased 5-year major adverse cardiovascular events and major adverse limb events. 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subjects antiplatelet therapy
endovascular revascularization
peripheral artery disease
title Optimal Strategy for Antiplatelet Therapy After Endovascular Revascularization for Lower Extremity Peripheral Artery Disease
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