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Intravascular ultrasound enhances the safety of rotational atherectomy Percutaneous Treatment and Outcomes of Small Coronary Vessels: A SCAAR Report Pulmonary hypertension is associated with an increased incidence of NAFLD: A retrospective cohort study of 18,910 patients Clinical Characteristics and Long-Term Outcomes of Rotational Atherectomy-J2T Multicenter Registry Procedural Success and Outcomes With Increasing Use of Enabling Strategies for Chronic Total Occlusion Intervention North American Expert Review of Rotational Atherectomy Orbital atherectomy for the treatment of small (2.5mm) severely calcified coronary lesions: ORBIT II sub-analysis The Regulation of Pulmonary Vascular Tone by Neuropeptides and the Implications for Pulmonary Hypertension Coronary Calcification and Long-Term Outcomes According to Drug-Eluting Stent Generation Pivotal trial to evaluate the safety and efficacy of the orbital atherectomy system in treating de novo, severely calcified coronary lesions (ORBIT II)
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Review ArticleVolume 13, Number 6, 2017 Aug 25

JOURNAL：EuroIntervention. Article Link

State of the art: duration of dual antiplatelet therapy after percutaneous coronary intervention and coronary stent implantation - past, present and future perspectives.

Gargiulo G, Valgimigli M, Capodanno D et al. Keywords: percutaneous coronary intervention ; dual antiplatelet therapy; randomised trials

ABSTRACT

Evidence from studies published more than 10 years ago suggested that patients receiving first-generation drug-eluting stents (DES) needed dual antiplatelet therapy (DAPT) for at least 12 months. Current evidence from randomised controlled trials (RCT) reported within the past five years suggests that patients with stable ischaemic heart disease who receive newer-generation DES need DAPT for a minimum of three to six months. Patients who undergo stenting for an acute coronary syndrome benefit from DAPT for at least 12 months, but a Bayesian network meta-analysis confirms that extending DAPT beyond 12 months confers a trade-off between reduced ischaemic events and increased bleeding. However, the network meta-analysis finds no credible increase in all-cause mortality if DAPT is lengthened from three to six months to 12 months (posterior median odds ratio [OR] 0.98; 95% Bayesian credible interval [BCI]: 0.73-1.43), from 12 months to 18-48 months (OR 0.87; 95% BCI: 0.64-1.17), or from three to six months to 18-48 months (OR 0.86; 95% BCI: 0.63-1.21). Future investigation should focus on identifying scoring systems that have excellent discrimination and calibration. Although predictive models should be incorporated into systems of care, most decisions about DAPT duration will be based on clinical judgement and patient preference.
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