SCI 발표논문

SCI 발표논문

← SCI 발표논문 목록

Circ Cardiovasc Interv. 2025;18(5):e014623.

Short-Term DAPT After Complex PCI With Third-Generation DES: A Post Hoc Analysis of the HOST-IDEA Trial.

, , , , , , , , , , , , , , , , , , ,

제1저자 한정규, 이기환 · 교신저자 김효수, 신상훈

PMID 40160090 DOI 10.1161/CIRCINTERVENTIONS.124.014623 IF 7.2 순환기내과
소속 (13)
  1. Cardiovascular Center, Seoul National University Hospital, Republic of Korea (J.-K.H., K.L., Sang-Hyeon Park, S.Y., D.H., J.K., H.-M.Y., K.W.P., H.-J.K., B.-K.K., H.-S.K.).
  2. Department of Internal Medicine, College of Medicine, Seoul National University, Republic of Korea (J.-K.H., H.-M.Y., K.W.P., H.-J.K., B.-K.K., S.-H.K., H.-S.K.).
  3. Division of Cardiology, Department of Medicine, Gangneung Asan Hospital, South Korea (K.L.).
  4. Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Republic of Korea (Sang-Hyun Park).
  5. Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea (S.-H.H.).
  6. Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea (W.K.).
  7. Division of Cardiology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea (S.H.H.).
  8. Division of Cardiology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Republic of Korea (S.-H.K.).
  9. Division of Cardiology, Department of Internal Medicine, Kangwon National University College of Medicine, Chuncheon, Republic of Korea (Y.H.K.).
  10. Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea (Y.H.K.).
  11. Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea (N.L.).
  12. Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Republic of Korea (S.J.L.).
  13. Department of Cardiology, Seoul Hospital, Ewha Womans University College of Medicine, Republic of Korea (S.S.).

Abstract

BACKGROUND The optimal duration of dual antiplatelet therapy (DAPT) after complex percutaneous coronary intervention (PCI) remains unclear. We aim to investigate the efficacy and safety of 3 to 6 months of DAPT over 12 months after complex PCI.

METHODS A post hoc analysis of the HOST-IDEA (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-Coronary Intervention With Next-Generation Drug-Eluting Stent Platforms and Abbreviated Dual Antiplatelet Therapy) randomized trial which enrolled patients undergoing PCI with third-generation drug-eluting stents was performed. Complex PCI was defined by any of the following: ≥3 stents implanted, ≥3 lesions treated, bifurcation PCI with 2-stenting, total stent length ≥60 mm, left main PCI, or heavy calcification. The major end points were target lesion failure, a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization for ischemic outcomes, and major bleeding, defined as BARC (Bleeding Academic Research Consortium) type 3 or 5, for bleeding outcomes at 12 months.

RESULTS Among 1992 patients, 624 underwent complex PCI. The complex PCI group had clinical features associated with high bleeding risk. A shortened DAPT duration did not increase the risk of target lesion failure, with hazard ratios of 0.818 (95% CI, 0.403-1.659) for the complex PCI group and 1.282 (95% CI, 0.506-3.249) for the noncomplex PCI group (Pinteraction=0.451). Conversely, it decreased the risk of major bleeding in the complex PCI group (hazard ratio, 0.269 [95% CI, 0.075-0.965]), but not in the noncomplex PCI group (hazard ratio, 1.534 [95% CI, 0.627-3.754], showing a significant interaction; Pinteraction=0.029).

CONCLUSIONS In patients undergoing complex PCI with a third-generation drug-eluting stent, a 3- to 6-month duration of DAPT was associated with a reduced risk of bleeding without an increased risk of ischemic events compared with 12-month DAPT.

REGISTRATION URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02601157.

Keywords

coronary artery diseasedrug-eluting stentspercutaneous coronary interventionrisk

Conflict of interest statement

Dr J.-K. Han reports grants from ChongKunDang and HanMi outside the submitted work. Dr K.W. Park received speaker fees from Daiichi Sankyo, AstraZeneca, Sanofi, Bristol-Myers Squibb, Bayer, and Pfizer outside the submitted work. Dr H.-S. Kim reports grants or speaker fees from Daiichi Sankyo, Boston Scientific, Terumo, Biotronik, Dio, Medtronic, Abbott Vascular, Edwards Life Science, Amgen, and Boehringer Ingelheim outside the submitted work. The other authors report no conflicts.

그 밖의 정보
출판 형태
Journal Article, Randomized Controlled Trial, Multicenter Study
저널
Circulation. Cardiovascular interventions · eISSN 1941-7632
전자 출판
2025-03-31
MeSH
Humans · Percutaneous Coronary Intervention* / adverse effects / mortality / instrumentation · Male · Female · Drug-Eluting Stents* · Time Factors · Platelet Aggregation Inhibitors* / administration & dosage / adverse effects · Aged · Middle Aged · Treatment Outcome · Coronary Artery Disease* / mortality / therapy / diagnostic imaging · Hemorrhage / chemically induced · Risk Factors · Dual Anti-Platelet Therapy* / adverse effects / mortality · Drug Administration Schedule · Risk Assessment · Prosthesis Design · Coronary Stenosis* / mortality / diagnostic imaging / therapy
Substances
Platelet Aggregation Inhibitors
데이터
ClinicalTrials.gov: NCT02601157