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- Publisher Website: 10.1136/postgradmedj-2019-136760
- Scopus: eid_2-s2.0-85076447908
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Article: Incidence of dual antiplatelet therapy interruption within 1 year after primary percutaneous coronary intervention in patients with acute ST elevation myocardial infarction
Title | Incidence of dual antiplatelet therapy interruption within 1 year after primary percutaneous coronary intervention in patients with acute ST elevation myocardial infarction |
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Authors | |
Keywords | coronary intervention myocardial infarction |
Issue Date | 2020 |
Publisher | BMJ Publishing Group. The Journal's web site is located at http://www.postgradmedj.com |
Citation | Postgraduate Medical Journal, 2020, v. 96 n. 1131, p. 9-13 How to Cite? |
Abstract | Background: After primary percutaneous coronary intervention (PPCI) in patients with acute ST elevation myocardial infarction (STEMI), dual antiplatelet therapy (DAPT) is recommended to continue for 1 year. Occasionally, DAPT interruption may be required due to bleeding issues or unplanned surgical procedures.
Objective: To systematically evaluate the incidence of DAPT interruption within 1 year after PPCI.
Methods and results: This was a single-centre, retrospective registry study. Consecutive patients with STEMI who underwent PPCI from 2013 to 2017 (N=538) were recruited into the analysis. The primary outcome was the incidence of interruption of DAPT within 1 year from the index PPCI. Secondary outcomes included incidence of bleeding in 1 year and prevalence of high bleeding risk (HBR) criteria at index presentation. Within 1 year, 17.1% (84/490) of post-PPCI survivors needed DAPT interruption and 7.1% (35/490) had major bleeding (Bleeding Academic Research Consortium type 3 or 5). At index presentation, HBR criteria were present in 36.1% (194/538) of patients. On univariate analysis, age, female gender, anaemia, anticoagulation, diabetes, hypertension and being a non-smoker were associated with DAPT interruption. On multivariate analysis, age was the only independent factor to predict DAPT interruption.
Conclusion: DAPT interruption was not uncommon after PPCI in patients with STEMI particularly in the elderly. This has implication on stent selection during PPCI, and further studies are required to investigate which type of stent may best suit our real-life patients with STEMI. |
Persistent Identifier | http://hdl.handle.net/10722/275127 |
ISSN | 2023 Impact Factor: 3.6 2023 SCImago Journal Rankings: 0.876 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Tam, CC | - |
dc.contributor.author | Lee, J | - |
dc.contributor.author | Chan, KW | - |
dc.contributor.author | Lam, CC | - |
dc.contributor.author | Wong, YT | - |
dc.contributor.author | Chan, E | - |
dc.contributor.author | Sze, M | - |
dc.contributor.author | Lam, YM | - |
dc.contributor.author | Chan, C | - |
dc.contributor.author | Tse, HF | - |
dc.contributor.author | Siu, CW | - |
dc.date.accessioned | 2019-09-10T02:36:01Z | - |
dc.date.available | 2019-09-10T02:36:01Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Postgraduate Medical Journal, 2020, v. 96 n. 1131, p. 9-13 | - |
dc.identifier.issn | 0032-5473 | - |
dc.identifier.uri | http://hdl.handle.net/10722/275127 | - |
dc.description.abstract | Background: After primary percutaneous coronary intervention (PPCI) in patients with acute ST elevation myocardial infarction (STEMI), dual antiplatelet therapy (DAPT) is recommended to continue for 1 year. Occasionally, DAPT interruption may be required due to bleeding issues or unplanned surgical procedures. Objective: To systematically evaluate the incidence of DAPT interruption within 1 year after PPCI. Methods and results: This was a single-centre, retrospective registry study. Consecutive patients with STEMI who underwent PPCI from 2013 to 2017 (N=538) were recruited into the analysis. The primary outcome was the incidence of interruption of DAPT within 1 year from the index PPCI. Secondary outcomes included incidence of bleeding in 1 year and prevalence of high bleeding risk (HBR) criteria at index presentation. Within 1 year, 17.1% (84/490) of post-PPCI survivors needed DAPT interruption and 7.1% (35/490) had major bleeding (Bleeding Academic Research Consortium type 3 or 5). At index presentation, HBR criteria were present in 36.1% (194/538) of patients. On univariate analysis, age, female gender, anaemia, anticoagulation, diabetes, hypertension and being a non-smoker were associated with DAPT interruption. On multivariate analysis, age was the only independent factor to predict DAPT interruption. Conclusion: DAPT interruption was not uncommon after PPCI in patients with STEMI particularly in the elderly. This has implication on stent selection during PPCI, and further studies are required to investigate which type of stent may best suit our real-life patients with STEMI. | - |
dc.language | eng | - |
dc.publisher | BMJ Publishing Group. The Journal's web site is located at http://www.postgradmedj.com | - |
dc.relation.ispartof | Postgraduate Medical Journal | - |
dc.rights | Postgraduate Medical Journal. Copyright © BMJ Publishing Group. | - |
dc.rights | This article has been accepted for publication in [Journal, Year] following peer review, and the Version of Record can be accessed online at [insert full DOI eg. http://dx.doi.org/10.1136/xxxxx]. [© Authors (or their employer(s)) OR © BMJ Publishing Group Ltd ( for assignments of BMJ Case Reports)] <year> | - |
dc.subject | coronary intervention | - |
dc.subject | myocardial infarction | - |
dc.title | Incidence of dual antiplatelet therapy interruption within 1 year after primary percutaneous coronary intervention in patients with acute ST elevation myocardial infarction | - |
dc.type | Article | - |
dc.identifier.email | Lam, YM: lamym2@hku.hk | - |
dc.identifier.email | Chan, C: drwschan@hkucc.hku.hk | - |
dc.identifier.email | Tse, HF: hftse@hkucc.hku.hk | - |
dc.identifier.email | Siu, CW: cwdsiu@hkucc.hku.hk | - |
dc.identifier.authority | Tse, HF=rp00428 | - |
dc.identifier.authority | Siu, CW=rp00534 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1136/postgradmedj-2019-136760 | - |
dc.identifier.scopus | eid_2-s2.0-85076447908 | - |
dc.identifier.hkuros | 304708 | - |
dc.identifier.volume | 96 | - |
dc.identifier.issue | 1131 | - |
dc.identifier.spage | 9 | - |
dc.identifier.epage | 13 | - |
dc.identifier.isi | WOS:000503819600004 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0032-5473 | - |