Prolonged Dual Antiplatelet Therapy in Acute Myocardial Infarction Patients Without Revascularization: China Acute Myocardial Infarction Registry Study
At least 12 months of dual antiplatelet therapy (DAPT) is 1 of the standards of care following percutaneous coronary intervention in patients with acute coronary syndrome. However, study on prolonged DAPT for patients with acute myocardial infarction (AMI) without revascularization is limited. We st...
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| Veröffentlicht in: | The American journal of cardiology 2024-04, Vol.217, p.39-48 |
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| creator | Huang, Cunrong Yang, Jingang Li, Ling He, Shenghu Zhang, Xuxia Xu, Haiyan Wu, Yuan Zhang, Jun Qiao, Shubin Wu, Yongjian Zhao, Yanyan Wang, Yang Li, Wei Jin, Chen Gao, Xiaojin Yang, Yuejin |
| description | At least 12 months of dual antiplatelet therapy (DAPT) is 1 of the standards of care following percutaneous coronary intervention in patients with acute coronary syndrome. However, study on prolonged DAPT for patients with acute myocardial infarction (AMI) without revascularization is limited. We studied 1,744 patients with AMI without revascularization from the China Acute Myocardial Infarction registry between January 2013 and September 2014. These patients were on DAPT and did not experience AMI, stroke, or bleeding events at the 12-month follow-up. We divided them into 2 groups: 12-month DAPT group (DAPT for at least 12 months but |
| doi_str_mv | 10.1016/j.amjcard.2024.02.010 |
| format | Article |
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However, study on prolonged DAPT for patients with acute myocardial infarction (AMI) without revascularization is limited. We studied 1,744 patients with AMI without revascularization from the China Acute Myocardial Infarction registry between January 2013 and September 2014. These patients were on DAPT and did not experience AMI, stroke, or bleeding events at the 12-month follow-up. We divided them into 2 groups: 12-month DAPT group (DAPT for at least 12 months but <18 months) and 18-month DAPT group (DAPT for at least 18 months). The primary outcome was 24-month all-cause death. Overall, 1,221 patients (70.0%) took DAPT for ≥12 months but <18 months, whereas 523 patients (30.0%) took DAPT for ≥18 months. The proportion of patients at high ischemic risk and the proportion of patients at high bleeding risk were similar in the 2 groups. At 24 months, the all-cause mortality rate of the 18-month DAPT group was significantly lower than that for the 12-month DAPT group (3.7% vs 5.9%, p = 0.0471). The adjusted hazard ratio for all-cause death also showed statistical significance (0.59, 95% confidence interval 0.35 to 0.99, p = 0.0444). In conclusion, DAPT for at least 18 months appears to be associated with lower 24-month mortality for non-revascularization AMI patients without events within 12 months after onset.</description><identifier>ISSN: 0002-9149</identifier><identifier>ISSN: 1879-1913</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2024.02.010</identifier><identifier>PMID: 38402925</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute coronary syndromes ; all-cause mortality ; Antiplatelet therapy ; Bleeding ; Cardiology ; Cerebral infarction ; Chi-square test ; Clinical outcomes ; Death ; Diabetes ; dual antiplatelet therapy ; Enzymes ; Heart attacks ; Hypertension ; Ischemia ; Mortality ; Myocardial infarction ; nonrevascularization ; Statistical analysis</subject><ispartof>The American journal of cardiology, 2024-04, Vol.217, p.39-48</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Apr 15, 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-d2a3c9a88c69210b764da69c659e8d14074c53c1ac546fbd07b30a393055e3c3</citedby><cites>FETCH-LOGICAL-c393t-d2a3c9a88c69210b764da69c659e8d14074c53c1ac546fbd07b30a393055e3c3</cites><orcidid>0000-0002-8158-484X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/3020341857?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38402925$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Cunrong</creatorcontrib><creatorcontrib>Yang, Jingang</creatorcontrib><creatorcontrib>Li, Ling</creatorcontrib><creatorcontrib>He, Shenghu</creatorcontrib><creatorcontrib>Zhang, Xuxia</creatorcontrib><creatorcontrib>Xu, Haiyan</creatorcontrib><creatorcontrib>Wu, Yuan</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>Qiao, Shubin</creatorcontrib><creatorcontrib>Wu, Yongjian</creatorcontrib><creatorcontrib>Zhao, Yanyan</creatorcontrib><creatorcontrib>Wang, Yang</creatorcontrib><creatorcontrib>Li, Wei</creatorcontrib><creatorcontrib>Jin, Chen</creatorcontrib><creatorcontrib>Gao, Xiaojin</creatorcontrib><creatorcontrib>Yang, Yuejin</creatorcontrib><creatorcontrib>CAMI (China Acute Myocardial Infarction) Registry study group</creatorcontrib><title>Prolonged Dual Antiplatelet Therapy in Acute Myocardial Infarction Patients Without Revascularization: China Acute Myocardial Infarction Registry Study</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>At least 12 months of dual antiplatelet therapy (DAPT) is 1 of the standards of care following percutaneous coronary intervention in patients with acute coronary syndrome. However, study on prolonged DAPT for patients with acute myocardial infarction (AMI) without revascularization is limited. We studied 1,744 patients with AMI without revascularization from the China Acute Myocardial Infarction registry between January 2013 and September 2014. These patients were on DAPT and did not experience AMI, stroke, or bleeding events at the 12-month follow-up. We divided them into 2 groups: 12-month DAPT group (DAPT for at least 12 months but <18 months) and 18-month DAPT group (DAPT for at least 18 months). The primary outcome was 24-month all-cause death. Overall, 1,221 patients (70.0%) took DAPT for ≥12 months but <18 months, whereas 523 patients (30.0%) took DAPT for ≥18 months. The proportion of patients at high ischemic risk and the proportion of patients at high bleeding risk were similar in the 2 groups. At 24 months, the all-cause mortality rate of the 18-month DAPT group was significantly lower than that for the 12-month DAPT group (3.7% vs 5.9%, p = 0.0471). The adjusted hazard ratio for all-cause death also showed statistical significance (0.59, 95% confidence interval 0.35 to 0.99, p = 0.0444). In conclusion, DAPT for at least 18 months appears to be associated with lower 24-month mortality for non-revascularization AMI patients without events within 12 months after onset.</description><subject>Acute coronary syndromes</subject><subject>all-cause mortality</subject><subject>Antiplatelet therapy</subject><subject>Bleeding</subject><subject>Cardiology</subject><subject>Cerebral infarction</subject><subject>Chi-square test</subject><subject>Clinical outcomes</subject><subject>Death</subject><subject>Diabetes</subject><subject>dual antiplatelet therapy</subject><subject>Enzymes</subject><subject>Heart attacks</subject><subject>Hypertension</subject><subject>Ischemia</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>nonrevascularization</subject><subject>Statistical 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Study</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2024-04-15</date><risdate>2024</risdate><volume>217</volume><spage>39</spage><epage>48</epage><pages>39-48</pages><issn>0002-9149</issn><issn>1879-1913</issn><eissn>1879-1913</eissn><abstract>At least 12 months of dual antiplatelet therapy (DAPT) is 1 of the standards of care following percutaneous coronary intervention in patients with acute coronary syndrome. However, study on prolonged DAPT for patients with acute myocardial infarction (AMI) without revascularization is limited. We studied 1,744 patients with AMI without revascularization from the China Acute Myocardial Infarction registry between January 2013 and September 2014. These patients were on DAPT and did not experience AMI, stroke, or bleeding events at the 12-month follow-up. We divided them into 2 groups: 12-month DAPT group (DAPT for at least 12 months but <18 months) and 18-month DAPT group (DAPT for at least 18 months). The primary outcome was 24-month all-cause death. Overall, 1,221 patients (70.0%) took DAPT for ≥12 months but <18 months, whereas 523 patients (30.0%) took DAPT for ≥18 months. The proportion of patients at high ischemic risk and the proportion of patients at high bleeding risk were similar in the 2 groups. At 24 months, the all-cause mortality rate of the 18-month DAPT group was significantly lower than that for the 12-month DAPT group (3.7% vs 5.9%, p = 0.0471). The adjusted hazard ratio for all-cause death also showed statistical significance (0.59, 95% confidence interval 0.35 to 0.99, p = 0.0444). In conclusion, DAPT for at least 18 months appears to be associated with lower 24-month mortality for non-revascularization AMI patients without events within 12 months after onset.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38402925</pmid><doi>10.1016/j.amjcard.2024.02.010</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-8158-484X</orcidid></addata></record> |
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| subjects | Acute coronary syndromes all-cause mortality Antiplatelet therapy Bleeding Cardiology Cerebral infarction Chi-square test Clinical outcomes Death Diabetes dual antiplatelet therapy Enzymes Heart attacks Hypertension Ischemia Mortality Myocardial infarction nonrevascularization Statistical analysis |
| title | Prolonged Dual Antiplatelet Therapy in Acute Myocardial Infarction Patients Without Revascularization: China Acute Myocardial Infarction Registry Study |
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