nach oben

Erschienen in:

01.08.2015 | Original article

Effectiveness of prolonged clopidogrel-based dual antiplatelet therapy after drug-eluting stent implantation

Evidence-based meta-analysis

verfasst von: Changzhi Liu, Mao Liu, MD, Dezhu Chen, MD, Haifeng Liu, MD, Qianhua Jiang, MD, Jianhai Lu, MD, Liuer Zuo, MD

Erschienen in: Herz | Ausgabe 5/2015

Einloggen, um Zugang zu erhalten

Abstract

The use of drug-eluting stents (DESs) for patients with coronary artery disease is widespread. DESs have been associated with a lower rate of repeat revascularization, death, and myocardial infarction compared with bare metal stents. However, DESs can lead to a prothrombotic environment in the coronary arteries, resulting in a higher rate of thrombotic events. To counteract this, dual-antiplatelet therapy (DAPT) consisting of aspirin and clopidogrel is recommended. Currently, there are no clear guidelines on the duration of DAPT. We therefore conducted a meta-analysis to assess the effectiveness of prolonged DAPT after DES implantation.

Park SJ, Kang SM, Park DW (2014) Dual antiplatelet therapy after drug-eluting stents: defining the proper duration. Coron Artery Dis 25:83–89CrossRefPubMed

O’Gara PT, Kushner FG, Ascheim DD et al (2013) 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 61:e78–e140CrossRefPubMed

Liu M, Chen J, Huang D et al (2014) Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: a meta-analysis of 3 randomized controlled trials. J Cardiovasc Pharmacol 64:41–46CrossRefPubMed

Finn AV, Joner M, Nakazawa G et al (2007) Pathological correlates of late drug-eluting stent thrombosis: strut coverage as a marker of endothelialization. Circulation 115:2435–2441CrossRefPubMed

Lee CW, Ahn JM, Park DW et al (2014) Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: a randomized, controlled trial. Circulation 129:304–312CrossRefPubMed

Elmariah S, Mauri L, Doros G et al (2014) Extended duration dual antiplatelet therapy and mortality: a systematic review and meta-analysis. Lancet doi:10.1016/S0140-6736(14)62052-3

Pfisterer M, Brunner-La RH, Buser PT et al (2006) Late clinical events after clopidogrel discontinuation may limit the benefit of drug-eluting stents: an observational study of drug-eluting versus bare-metal stents. J Am Coll Cardiol 48:2584–2591CrossRefPubMed

Stone GW, Moses JW, Ellis SG et al (2007) Safety and efficacy of sirolimus- and paclitaxel-eluting coronary stents. N Engl J Med 356:998–1008CrossRefPubMed

Spaulding C, Daemen J, Boersma E et al (2007) A pooled analysis of data comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med 356:989–997CrossRefPubMed

10.

Airoldi F, Colombo A, Morici N et al (2007) Incidence and predictors of drug-eluting stent thrombosis during and after discontinuation of thienopyridine treatment. Circulation 116:745–754CrossRefPubMed

11.

Schulz S, Schuster T, Mehilli J et al (2009) Stent thrombosis after drug-eluting stent implantation: incidence, timing, and relation to discontinuation of clopidogrel therapy over a 4-year period. Eur Heart J 30:2714–2721CrossRefPubMed

12.

Gwon HC, Hahn JY, Park KW et al (2012) Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents: the Efficacy of Xience/Promus Versus Cypher to Reduce Late Loss After Stenting (EXCELLENT) randomized, multicenter study. Circulation 125:505–513CrossRefPubMed

13.

Valgimigli M, Campo G, Monti M et al (2012) Short- versus long-term duration of dual-antiplatelet therapy after coronary stenting: a randomized multicenter trial. Circulation 125:2015–2026CrossRefPubMed

14.

Kim BK, Hong MK, Shin DH et al (2012) A new strategy for discontinuation of dual antiplatelet therapy: the RESET Trial (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation). J Am Coll Cardiol 60:1340–1348CrossRefPubMed

15.

Park SJ, Park DW, Kim YH et al (2010) Duration of dual antiplatelet therapy after implantation of drug-eluting stents. N Engl J Med 362:1374–1382CrossRefPubMed

16.

Laskey WK, Yancy CW, Maisel WH (2007) Thrombosis in coronary drug-eluting stents: report from the meeting of the Circulatory System Medical Devices Advisory Panel of the Food and Drug Administration Center for Devices and Radiologic Health, December 7–8, 2006. Circulation 115:2352–2357CrossRefPubMed

17.

Wiviott SD, Antman EM, Gibson CM et al (2006) Evaluation of prasugrel compared with clopidogrel in patients with acute coronary syndromes: design and rationale for the TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet InhibitioN with prasugrel Thrombolysis In Myocardial Infarction 38 (TRITON-TIMI 38). Am Heart J 152:627–635CrossRefPubMed

18.

Mao L, Jian C, Changzhi L et al (2013) Cytochrome CYP2C19 polymorphism and risk of adverse clinical events in clopidogrel-treated patients: a meta-analysis based on 23,035 subjects. Arch Cardiovasc Dis 106:517–527CrossRefPubMed

19.

Lo CK, Mertz D, Loeb M (2014) Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol 14:45PubMedCentralCrossRefPubMed

20.

Yu X, Chen F, He J et al (2013) Duration of dual antiplatelet therapy after implantation of the first-generation and second-generation drug-eluting stents. Coron Artery Dis 24:217–223CrossRefPubMed

21.

Sardella G, Mancone M, Biondi-Zoccai G et al (2012) Beneficial impact of prolonged dual antiplatelet therapy after drug-eluting stent implantation. J Interv Cardiol 25:596–603CrossRefPubMed

22.

Poorhosseini HR, Hosseini SK, Davarpasand T et al (2012) Effectiveness of Two-Year versus One-Year Use of Dual Antiplatelet Therapy in Reducing the Risk of Very Late Stent Thrombosis after Drug-Eluting Stent Implantation. J Tehran Heart Cent 7:47–52PubMedCentralPubMed

23.

Gao Y, Yu X, He J et al (2012) Duration of dual antiplatelet therapy after implantation of drug-eluting stents (Article in Chinese). J Cardiovasc Pulmon Dis 31:409–411

24.

Tang X, Zhou Z, Hua G et al (2011) Comparison of two year duration versus one year duration of dual antiplatelet therapy after drug-eluting stent implantation on major adverse cardiac event (Article in Chinese). Chin J Intervent Cardiol 19:147–149

25.

Tanzilli G, Greco C, Pelliccia F et al (2009) Effectiveness of two-year clopidogrel + aspirin in abolishing the risk of very late thrombosis after drug-eluting stent implantation (from the TYCOON [two-year ClOpidOgrel need] study). Am J Cardiol 104:1357–1361CrossRefPubMed

26.

Cassese S, Byrne RA, Tada T et al (2012) Clinical impact of extended dual antiplatelet therapy after percutaneous coronary interventions in the drug-eluting stent era: a meta-analysis of randomized trials. Eur Heart J 33:3078–3087CrossRefPubMed

27.

Valgimigli M, Park SJ, Kim HS et al (2013) Benefits and risks of long-term duration of dual antiplatelet therapy after drug-eluting stenting: a meta-analysis of randomized trials. Int J Cardiol 168:2579–2587CrossRefPubMed

Titel: Effectiveness of prolonged clopidogrel-based dual antiplatelet therapy after drug-eluting stent implantation
Evidence-based meta-analysis
verfasst von: Changzhi Liu
Mao Liu, MD
Dezhu Chen, MD
Haifeng Liu, MD
Qianhua Jiang, MD
Jianhai Lu, MD
Liuer Zuo, MD
Publikationsdatum: 01.08.2015
Verlag: Urban & Vogel
Erschienen in: Herz / Ausgabe 5/2015
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-015-4304-5

Neu im Fachgebiet Kardiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2015

Interventionelle Therapie struktureller Herzerkrankungen

Erratum to: Left ventricular pseudoaneurysm after mitral valve replacement

Therapie der akuten Herzinsuffizienz

Mitochondrial coupling factor 6 upregulation in hypertension-induced cardiac hypertrophy

Comparison of Exo-Seal® and Angio-Seal® for arterial puncture site closure