Outcomes of Percutaneous Coronary Intervention Performed With or Without Preprocedural Dual Antiplatelet Therapy

DOI Web Site Web Site PubMed 被引用文献3件
  • Ikegami Yukinori
    Department of Cardiology, National Hospital Organization, Tokyo Medical Center
  • Kohsaka Shun
    Department of Cardiology, Keio University School of Medicine
  • Miyata Hiroaki
    Department of Healthcare Quality Assessment, The University of Tokyo
  • Ueda Ikuko
    Department of Cardiology, Keio University School of Medicine
  • Fuse Jun
    Department of Cardiology, National Hospital Organization, Tokyo Medical Center
  • Sakamoto Munehisa
    Department of Cardiology, National Hospital Organization, Tokyo Medical Center
  • Shiraishi Yasuyuki
    Department of Cardiology, Keio University School of Medicine
  • Numasawa Yohei
    Department of Cardiology, Ashikaga Red Cross Hospital
  • Negishi Koji
    Department of Cardiology, Yokohama Municipal Hospital
  • Nakamura Iwao
    Department of Cardiology, Hino Municipal Hospital
  • Maekawa Yuichiro
    Department of Cardiology, Keio University School of Medicine
  • Momiyama Yukihiko
    Department of Cardiology, National Hospital Organization, Tokyo Medical Center
  • Fukuda Keiichi
    Department of Cardiology, Keio University School of Medicine

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Background:Preprocedural dual antiplatelet therapy (DAPT) in percutaneous coronary interventions (PCI) has been shown to improve outcomes; however, the efficacy of the procedure and its complications in Japanese patients remain largely unexplored, so we examined the risks and benefits of DAPT before PCI and its association with in-hospital outcomes.Methods and Results:We analyzed data from patients who had undergone PCI at 12 centers within the metropolitan Tokyo area between September 2008 and September 2013.Our study group comprised 6,528 patients, of whom 2,079 (31.8%) were not administered preprocedural DAPT. Non-use of preprocedural DAPT was associated with death, postprocedural shock, or heart failure (odds ratio [OR]: 1.47, 95% confidence interval [CI]: 1.10–1.96, P=0.009), and postprocedural myocardial infarction (OR: 1.41, 95% CI: 1.18–1.69, P<0.001) after adjusting propensity scores for known predictors of in-hospital complications. Non-use of DAPT was not associated with procedure-related bleeding complications (OR: 0.98, 95% CI: 0.71–1.59, P=0.764).Conclusions:Approximately one-third of the patients who underwent PCI did not receive preprocedural DAPT despite guideline recommendations. Our results indicate that patients undergoing PCI with DAPT have a lower risk of postprocedural cardiac events without any increased bleeding risk. Further studies are needed to implement the use of DAPT in real-world PCI. (Circ J 2015; 79: 2598–2607)

収録刊行物

  • Circulation Journal

    Circulation Journal 79 (12), 2598-2607, 2015

    一般社団法人 日本循環器学会

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