PMID- 37068941
OWN - NLM
STAT- MEDLINE
DCOM- 20240115
LR  - 20240210
IS  - 1759-8486 (Electronic)
IS  - 1759-8478 (Print)
IS  - 1759-8478 (Linking)
VI  - 16
IP  - 2
DP  - 2024 Jan 12
TI  - Short- versus long-term Dual AntiPlatelet Therapy for Stent-Assisted treatment of 
      CErebral aneurysm (DAPTS ACE): a multicenter, open-label, randomized clinical 
      trial.
PG  - 171-176
LID - 10.1136/jnis-2022-019867 [doi]
AB  - BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) after 
      stent-assisted coil embolization (SACE) for cerebral aneurysm remains uncertain. 
      This randomized trial of short- versus long-term Dual AntiPlatelet Therapy for 
      Stent-Assisted treatment of CErebral aneurysm (DAPTS ACE) aimed to clarify 
      whether long-term DAPT can reduce the occurrence of ischemic stroke in patients 
      with cerebral aneurysms treated by SACE compared with short-term DAPT. METHODS: 
      Patients treated for cerebral aneurysm with SACE were enrolled from 17 hospitals 
      in Japan. Patients were enrolled within 30 days after SACE and assigned in a 1:1 
      ratio to receive long-term (12 months) or short-term (3 months) DAPT with aspirin 
      and clopidogrel. Randomization was performed centrally through a web-based 
      system. The primary outcome was the time to ischemic stroke event during 3 to 12 
      months after SACE. This trial was registered with the Japan Registry of Clinical 
      Trials (jRCTs051180141). RESULTS: A total of 142 patients were recruited from 
      November 4, 2016 to January 7, 2019. Among them, 65 and 68 patients assigned to 
      the long- and short-term DAPT groups, respectively, were included in the full 
      analysis set. Ischemic stroke occurred in no patients in the long-term DAPT group 
      and in one patient in the short-term DAPT group. The incidence rate did not 
      differ between the groups (0.0 vs 2.1/100 person-years; log rank test, P=0.33). 
      CONCLUSIONS: In this multicenter randomized controlled trial, there was not a 
      statistically significant difference in the rate of ischemic strokes between 
      long- and short-term DAPT.
CI  - (c) Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Ozaki, Tomohiko
AU  - Ozaki T
AUID- ORCID: 0000-0003-1558-4785
AD  - Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, 
      Japan.
FAU - Yamagami, Hiroshi
AU  - Yamagami H
AD  - Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, 
      Japan yamagami.brain@outlook.com.
FAU - Morimoto, Masafumi
AU  - Morimoto M
AD  - Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Kanagawa, 
      Japan.
FAU - Hatano, Taketo
AU  - Hatano T
AD  - Neurosurgery, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan.
FAU - Oishi, Hidenori
AU  - Oishi H
AD  - Neurosurgery, Juntendo University, Faculty of Medicine, Tokyo, Japan.
AD  - Neuroendovascular Therapy, Juntendo University, Faculty of Medicine, Tokyo, 
      Japan.
FAU - Haraguchi, Koichi
AU  - Haraguchi K
AD  - Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan.
FAU - Yoshimura, Shinichi
AU  - Yoshimura S
AD  - Neurosurgery, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
FAU - Sugiu, Kenji
AU  - Sugiu K
AD  - Neurosurgery, Okayama University Graduate School of Medicine, Dentistry and 
      Pharmaceutical Sciences, Okayama, Okayama, Japan.
FAU - Iihara, Koji
AU  - Iihara K
AD  - Neurosurgery, National Cerebral and Cardiovascular Center Hospital, Suita, Osaka, 
      Japan.
FAU - Matsumaru, Yuji
AU  - Matsumaru Y
AD  - Division of Stroke Prevention and Treatment, Department of Neurosurgery, 
      University of Tsukuba Faculty of Medicine, Tsukuba, Ibaraki, Japan.
FAU - Matsumoto, Yasushi
AU  - Matsumoto Y
AD  - Division of Development and Discovery of Interventional Therapy, Tohoku 
      University Hospital, Sendai, Miyagi, Japan.
FAU - Satow, Tetsu
AU  - Satow T
AD  - Neurosurgery, Kindai University, Osaka-Sayama, Osaka, Japan.
FAU - Hayakawa, Mikito
AU  - Hayakawa M
AD  - Division of Stroke Prevention and Treatment, Department of Neurosurgery, 
      University of Tsukuba Faculty of Medicine, Tsukuba, Ibaraki, Japan.
FAU - Sakai, Chiaki
AU  - Sakai C
AD  - Neurosurgery, Kobe City Medical Center General Hospital, Kobe-city, Japan.
FAU - Miyamoto, Susumu
AU  - Miyamoto S
AD  - Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
FAU - Kitagawa, Kazuo
AU  - Kitagawa K
AD  - Neurology, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, 
      Tokyo, Japan.
FAU - Daimon, Takashi
AU  - Daimon T
AD  - Biostatistics, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
FAU - Kagimura, Tatsuo
AU  - Kagimura T
AD  - Foundation for Biomedical Research and Innovation at Kobe, Translational Research 
      Center for Medical Innovation, Kobe, Hyogo, Japan.
FAU - Sakai, Nobuyuki
AU  - Sakai N
AD  - Neurosurgery, Kobe City Medical Center General Hospital, Kobe-city, Hyogo, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20240112
PL  - England
TA  - J Neurointerv Surg
JT  - Journal of neurointerventional surgery
JID - 101517079
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Humans
MH  - Platelet Aggregation Inhibitors
MH  - *Intracranial Aneurysm/diagnostic imaging/drug therapy
MH  - Aspirin
MH  - Stents
MH  - Drug Therapy, Combination
MH  - *Ischemic Stroke/etiology
MH  - *Percutaneous Coronary Intervention
MH  - Treatment Outcome
PMC - PMC10850618
OTO - NOTNLM
OT  - Aneurysm
OT  - Drug
OT  - Intervention
COIS- Competing interests: HY reports research grants from Bristol-Myers Squibb; 
      lecturer's fees from Stryker, Medtronic, Terumo, Johnson & Johnson, Biomedical 
      Solutions, Bristol-Myers Squibb, Daiichi Sankyo, and Medico's Hirata. HO reports 
      research grants from Terumo, Stryker, Medtronic, Medikit, and Kaneka; and 
      consulting fees from Medtronic, Stryker, Kaneka, and Asahi Intec. KS reports 
      lecturer's fees from Medtronic Japan, Kaneka Medix and Terumo. YuM reports 
      lecturer's fees from Daiichi Sakyo, Otsuka Pharmaceutical, Medtronic, Stryker, 
      Terumo, Johnson & Johnson, Kaneka, and Medicos Hirata. KK reports lecturer's fee 
      from Kyowa Kirin and Daiichi Sankyo. YaM reports advisory role for GE Health 
      Care, Fuji Systems, Medicos Hirata, and Stryker; patents and royalties from 
      Sumitomo Bakelite; lecturer's fee from GE Healthcare, Stryker, Medtronic, 
      Medico's Hirata, Century Medical, Takeda Pharmaceutical Company, Otsuka 
      Pharmaceutical, Kaneka, and Fuji Systems. TS reports research grants from CANON 
      Medical Systems. TD reports consultant fees from Ajinomoto, Astellas Pharma, 
      Daiichi Sankyo, Eisai, Ferring Pharmaceuticals, Healios, Integral Geometry 
      Science, Ono Pharmaceutical, Periotherapia, and Terumo; lecturer's fee from 
      Bayer, Chugai Pharmaceutical, Daiichi Sankyo, Ono Pharmaceutical, and Takeda 
      Pharmaceutical Company; participation fees on Data Safety Monitoring Boards or 
      Advisory Boards from Astellas Pharma, Eisai, and Terumo Corporation, outside of 
      the submitted work. NS reports a research grant from Biomedical Solutions, 
      Medtronic and Terumo; lecturer's fees from Asahi-Intec, Biomedical Solutions, 
      Medtronic, and Terumo; membership on the advisory boards for Johnson&Johnson, 
      Medtronic and Terumo outside the submitted work.
EDAT- 2023/04/18 06:00
MHDA- 2024/01/15 12:42
PMCR- 2024/02/08
CRDT- 2023/04/17 21:41
PHST- 2022/11/12 00:00 [received]
PHST- 2023/04/02 00:00 [accepted]
PHST- 2024/01/15 12:42 [medline]
PHST- 2023/04/18 06:00 [pubmed]
PHST- 2023/04/17 21:41 [entrez]
PHST- 2024/02/08 00:00 [pmc-release]
AID - jnis-2022-019867 [pii]
AID - 10.1136/jnis-2022-019867 [doi]
PST - epublish
SO  - J Neurointerv Surg. 2024 Jan 12;16(2):171-176. doi: 10.1136/jnis-2022-019867.