左主干暨冠状动脉分叉病变峰会，CBS2019 - CBS 2019

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Left Main & Coronary Bifurcation Summit (CBS) was founded in 2006 as a think tank dedicated to the treatment of left main and coronary bifurcation lesions. CBS aims to improve cardiological care by refreshing fundamental researches, clinical trials, yearly published guidelines, emerged ideas and case-based discussion.

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  Nanjing Heart Center
  
  Asian Bifurcation Club (ABC)
  
  Nanjing First Hospital, Nanjing Medical University
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  Chinese Society of Cardiology (CSC)
  
  Capacity Building and Continuing Education Center,National Health and Family Planning Commission (CBCEC)
  
  American Society for Cardiovascular Angiography and Interventions (SCAI)
  
  Asian Heart Society (AHS)
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  Hongjuan Peng : +86-13913895477
  
  Haimei Xu +86-13914736846
  
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  Ling Lin : +86 (25) 52271398
  
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- Management of Challenging Cases
  
  Yingying Zhao :+86-13815408517
  
  sub@cbsmd.cn
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COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up

CSC Expert Consensus on Principles of Clinical Management of Patients with Severe Emergent Cardiovascular Diseases during the COVID-19 Epidemic

ACC Clinical Bulletin Focuses on Cardiac Implications of Coronavirus (COVID-19)

HOME | SCIENTIFIC LIBRARY | DAPT Duration

DAPT Duration

6- Versus 24-Month Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents in Patients Nonresistant to Aspirin Final Results of the ITALIC Trial (Is There a Life for DES After Discontinuation of Clopidogrel) Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation Antibody-Based Ticagrelor Reversal Agent in Healthy Volunteers Dual Antiplatelet TherapyIs It Time to Cut the Cord With Aspirin? Low-Dose Aspirin Discontinuation and Risk of Cardiovascular Events: A Swedish Nationwide, Population-Based Cohort Study Risk of Early Adverse Events After Clopidogrel Discontinuation in Patients Undergoing Short-Term Dual Antiplatelet Therapy: An Individual Participant Data Analysis 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 ISAR-SAFE: a randomized, double-blind, placebo-controlled trial of 6 vs. 12 months of clopidogrel therapy after drug-eluting stenting

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Clinical Trial2017 Jun 26;10(12):1202-1210.

JOURNAL：JACC Cardiovasc Interv. Article Link

6- Versus 24-Month Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents in Patients Nonresistant to Aspirin Final Results of the ITALIC Trial (Is There a Life for DES After Discontinuation of Clopidogrel)

Didier R, Morice MC, Gilard M et al. Keywords: drug-eluting stent(s); dual antiplatelet therapy; percutaneous coronary intervention

ABSTRACT

OBJECTIVES - The aim of this study was to test the hypothesis that 6-month dual antiplatelet therapy (DAPT) is noninferior to 24-month DAPT in aspirin-sensitive patients.

BACKGROUND - The ITALIC (Is There a Life for DES After Discontinuation of Clopidogrel) trial showed that rates of bleeding and thrombotic events at 1 year were much the same with 6 versus 12 months of DAPT after percutaneous coronary intervention with second-generation drug-eluting stents. In this report, 2-year follow-up is presented.

METHODS - In a multicenter randomized study, patients with confirmed nonresistance to aspirin undergoing drug-eluting stent implantation were allocated to 6 or 24 months of DAPT. The primary endpoint was a composite of death, myocardial infarction, urgent target vessel revascularization, stroke, and major bleeding at 12 months post-percutaneous coronary intervention. The secondary endpoints comprised the same composite endpoint at 24 months and each individual component.

RESULTS - Overall, 2,031 patients from 70 centers were screened; 926 were randomized to 6-month and 924 to 24-month DAPT. Noninferiority was demonstrated for 6- versus 12-month DAPT, with an absolute risk difference of 0.11% (95% confidence interval: -1.04% to 1.26%; p = 0.0002). At 2 years, the composite endpoint was unchanged, at 3.5% for 6 months and 3.7% for 24 months (p = 0.79), and rates of myocardial infarction (1.3% vs. 1.0%; p = 0.51), stroke (0.6% vs. 0.8%; p = 0.77), and target vessel revascularization (1.0% vs. 0.3%; p = 0.09) were likewise similar. There was a trend toward higher mortality with longer DAPT (2.2% vs. 1.2%; p = 0.11). Four patients (0.4%) in the 24-month group and none in the 6-month group had major bleeding.

CONCLUSIONS - Two-year outcomes in the ITALIC trial confirmed the 1-year results and showed that patients receiving 6-month DAPT after percutaneous coronary intervention with second-generation drug-eluting stent have similar outcomes to those receiving 24-month DAPT.

Abstract

Recommended Article

6- Versus 24-Month Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents in Patients Nonresistant to Aspirin Final Results of the ITALIC Trial (Is There a Life for DES After Discontinuation of Clopidogrel)

ABSTRACT