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The validation of the dual antiplatelet therapy score in East Asians receiving percutaneous coronary intervention with exclusively second generation drug‐eluting stents
Author(s) -
Kim Minkwan,
Park Kyung Woo,
Lee Hak Seung,
Ki YouJeong,
Kang Jeehoon,
Kim CheeHoon,
Han JungKyu,
Yang HanMo,
Kang HyunJae,
Koo BonKwon,
Kim HyoSoo
Publication year - 2021
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.29682
Subject(s) - medicine , percutaneous coronary intervention , hazard ratio , timi , myocardial infarction , cardiology , clinical endpoint , confidence interval , stent , propensity score matching , drug eluting stent , acute coronary syndrome , surgery , randomized controlled trial
Objectives We investigated whether the dual antiplatelet therapy (DAPT) score (DS) predicts clinical outcome in an East‐Asian population that received exclusively second generation drug‐eluting stent (DES). Backgrounds It is uncertain whether the DS could adequately risk stratify patients exclusively receiving second generation DES. Methods From the Grand‐DES registry, we evaluated patients who were treated with DAPT for at least 12 months and were event‐free at 12 months after DES implantation. Patients were classified into two categories: high DS (≧2) ( n = 3,157); and low DS (<2) ( n = 5,226). The primary ischemic outcome was a composite of stent thrombosis and all myocardial infarction (MI), and the primary bleeding outcome was TIMI major or minor bleeding. A propensity score (PS)‐matched analysis was done to correct for baseline differences between extended DAPT group and the conventional group. Results Among 8,383 subjects, the primary ischemic outcome occurred in 48 patients (0.6%) and the primary bleeding outcome in 49 patients (0.6%). High DS was associated with a higher incidence of ischemic events (ischemic outcome: 0.8% vs. 0.4%, for high vs. low DS, Log‐rank p = .039), but not with any differences in bleeding events (Log‐rank p = .734). In the PS‐matched analysis, extended group was associated with lower risk of composite endpoint of MI, stent thrombosis, or cardiac death in only the high DS group (1.8% vs. 3.7%, Log‐rank p = .004; hazard ratio 0.45, 95% confidence interval 0.27–0.76; p = .003 after adjustment). Conclusions The DS was an adequate risk stratifier for future ischemic events in East Asians receiving exclusively second generation DES.