PMID- 31324730
OWN - NLM
STAT- MEDLINE
DCOM- 20200603
LR  - 20200603
IS  - 1469-0756 (Electronic)
IS  - 0032-5473 (Linking)
VI  - 96
IP  - 1131
DP  - 2020 Jan
TI  - Incidence of dual antiplatelet therapy interruption within 1 year after primary 
      percutaneous coronary intervention in patients with acute ST elevation myocardial 
      infarction.
PG  - 9-13
LID - 10.1136/postgradmedj-2019-136760 [doi]
AB  - 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.
CI  - (c) Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Tam, Chor Cheung
AU  - Tam CC
AUID- ORCID: 0000-0003-4159-7635
AD  - Medicine, University of Hong Kong, Hong Kong, China frankie.tamcc@gmail.com.
FAU - Lee, Jeffrey
AU  - Lee J
AD  - Medicine, University of Hong Kong, Hong Kong, China.
FAU - Chan, Ki Wan
AU  - Chan KW
AD  - Medicine, University of Hong Kong, Hong Kong, China.
FAU - Lam, Cheung Chi
AU  - Lam CC
AD  - Medicine, University of Hong Kong, Hong Kong, China.
FAU - Wong, Yiu Tung
AU  - Wong YT
AD  - Medicine, University of Hong Kong, Hong Kong, China.
FAU - Chan, Eric
AU  - Chan E
AD  - Medicine, University of Hong Kong, Hong Kong, China.
FAU - Sze, Michael
AU  - Sze M
AD  - Medicine, University of Hong Kong, Hong Kong, China.
FAU - Lam, Yui Ming
AU  - Lam YM
AD  - Medicine, University of Hong Kong, Hong Kong, China.
FAU - Chan, Carmen
AU  - Chan C
AD  - Medicine, University of Hong Kong, Hong Kong, China.
FAU - Tse, Hung Fat
AU  - Tse HF
AD  - Medicine, University of Hong Kong, Hong Kong, China.
FAU - Siu, Chung Wah
AU  - Siu CW
AD  - Medicine, University of Hong Kong, Hong Kong, China.
LA  - eng
PT  - Journal Article
DEP - 20190719
PL  - England
TA  - Postgrad Med J
JT  - Postgraduate medical journal
JID - 0234135
SB  - IM
MH  - *Dual Anti-Platelet Therapy/adverse effects/methods
MH  - Female
MH  - *Hemorrhage/chemically induced/prevention & control/therapy
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Patient Selection
MH  - *Percutaneous Coronary Intervention/instrumentation/methods
MH  - *Postoperative Complications/etiology/prevention & control
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/*surgery
MH  - Stents/standards
MH  - Surgical Procedures, Operative/adverse effects/methods
MH  - Withholding Treatment/statistics & numerical data
OTO - NOTNLM
OT  - coronary intervention
OT  - myocardial infarction
COIS- Competing interests: None declared.
EDAT- 2019/07/22 06:00
MHDA- 2020/06/04 06:00
CRDT- 2019/07/21 06:00
PHST- 2019/05/10 00:00 [received]
PHST- 2019/07/02 00:00 [revised]
PHST- 2019/07/09 00:00 [accepted]
PHST- 2019/07/22 06:00 [pubmed]
PHST- 2020/06/04 06:00 [medline]
PHST- 2019/07/21 06:00 [entrez]
AID - postgradmedj-2019-136760 [pii]
AID - 10.1136/postgradmedj-2019-136760 [doi]
PST - ppublish
SO  - Postgrad Med J. 2020 Jan;96(1131):9-13. doi: 10.1136/postgradmedj-2019-136760. 
      Epub 2019 Jul 19.