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Duration of dual antiplatelet therapy in elective drug‐coated balloon angioplasty
Author(s) -
Corballis Natasha H.,
Wickramarachchi Upul,
Vassiliou Vassilios S.,
Eccleshall Simon C.
Publication year - 2020
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28632
Subject(s) - medicine , angioplasty , myocardial infarction , restenosis , coronary artery disease , conventional pci , population , revascularization , surgery , cardiology , stent , environmental health
Objectives We sought to answer whether 1‐month duration of dual antiplatelet therapy (DAPT) is safe after elective drug‐coated balloon only (DCB) angioplasty. Background The duration of DAPT after elective DCB was called into question after the ESC Focused DAPT Update of 2017. Until then, a 1‐month duration of DAPT was considered safe by national consensus groups (German, Italian, and Chinese) supported by data from prospective worldwide registries. The ESC Guidelines recommended a 6‐month duration of DAPT based on evidence from in‐stent restenosis randomized controlled trials only. Methods Retrospective, real‐world population, single‐center analysis conducted from January 1, 2012 to March 31, 2017 in a high‐volume, tertiary PCI center. Consecutive patients receiving 1‐month duration of DAPT after elective DCB angioplasty were included. We identified a primary composite outcome of cardiac death, myocardial infarction and target lesion revascularization at 6‐months. Results A total of 303 patients (78.5% male) with mean age of 67 ± 12.5 were included. This incorporated 86.1% de novo lesions and 56.5% nonsmall (≥3 mm diameter) coronary arteries treated. There were no reported outcomes of lesion thrombosis, target vessel MI, target lesion revascularization or cardiac death at 6‐months. There were two (0.6%) nontarget vessel MIs and one (0.3%) noncardiac death. Conclusion One‐month duration of DAPT appears safe after elective DCB‐only angioplasty, highlighting this strategy for patients at high‐risk of bleeding. These results also show favorable clinical outcomes for de novo coronary artery disease and nonsmall coronary arteries treated with DCB‐only angioplasty. A 1‐month duration of DAPT appears a safe and attractive option.