Investigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.

<h4>Background</h4>Dual antiplatelet therapy (DAPT) is currently the standard treatment for the prevention of ischemic events after stent implantation. However, the optimal DAPT duration remains elusive for patients with chronic kidney disease (CKD). Therefore, we aimed to compare the ef...

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Autores principales:	Chih-Chin Kao, Mai-Szu Wu, Ming-Tsang Chuang, Yi-Cheng Lin, Chun-Yao Huang, Wei-Chiao Chang, Chih-Wei Chen, Tzu-Hao Chang
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/afda8bca7355416db224ec85ebd112aa
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spelling	oai:doaj.org-article:afda8bca7355416db224ec85ebd112aa2021-12-02T20:15:16ZInvestigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.1932-620310.1371/journal.pone.0255645https://doaj.org/article/afda8bca7355416db224ec85ebd112aa2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255645https://doaj.org/toc/1932-6203<h4>Background</h4>Dual antiplatelet therapy (DAPT) is currently the standard treatment for the prevention of ischemic events after stent implantation. However, the optimal DAPT duration remains elusive for patients with chronic kidney disease (CKD). Therefore, we aimed to compare the effectiveness and safety between long-term and short-term DAPT after coronary stenting in patients with CKD.<h4>Methods</h4>This retrospective cohort study analyze data from the Taipei Medical University (TMU) Institutional and Clinical Database, which include anonymized electronic health data of 3 million patients that visited TMU Hospital, Wan Fang Hospital, and Shuang Ho Hospital. We enrolled patients with CKD after coronary stenting between 2008 and 2019. The patients were divided into the long-term (>6 months) and short-term DAPT group (≤ 6 months). The primary end point was major adverse cardiovascular events (MACE) from 6 months after the index date. The secondary outcomes were all-cause mortality and Thrombolysis in Myocardial Infarction (TIMI) bleeding.<h4>Results</h4>A total of 1899 patients were enrolled; of them, 1112 and 787 were assigned to the long-term and short-term DAPT groups, respectively. Long-term DAPT was associated with similar risk of MACE (HR: 1.05, 95% CI: 0.65-1.70, P = 0.83) compare with short-term DAPT. Different CKD risk did not modify the risk of MACE. There was also no significant difference in all-cause mortality (HR: 1.10, 95% CI: 0.75-1.61, P = 0.63) and TIMI bleeding (HR 1.19, 95% CI: 0.86-1.63, P = 0.30) between groups.<h4>Conclusions</h4>Among patients with CKD and coronary stenting, we found that long-term and short-term DAPT tied on the risk of MACE, all-cause mortality and TIMI bleeding.Chih-Chin KaoMai-Szu WuMing-Tsang ChuangYi-Cheng LinChun-Yao HuangWei-Chiao ChangChih-Wei ChenTzu-Hao ChangPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255645 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chih-Chin Kao Mai-Szu Wu Ming-Tsang Chuang Yi-Cheng Lin Chun-Yao Huang Wei-Chiao Chang Chih-Wei Chen Tzu-Hao Chang Investigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.
description	<h4>Background</h4>Dual antiplatelet therapy (DAPT) is currently the standard treatment for the prevention of ischemic events after stent implantation. However, the optimal DAPT duration remains elusive for patients with chronic kidney disease (CKD). Therefore, we aimed to compare the effectiveness and safety between long-term and short-term DAPT after coronary stenting in patients with CKD.<h4>Methods</h4>This retrospective cohort study analyze data from the Taipei Medical University (TMU) Institutional and Clinical Database, which include anonymized electronic health data of 3 million patients that visited TMU Hospital, Wan Fang Hospital, and Shuang Ho Hospital. We enrolled patients with CKD after coronary stenting between 2008 and 2019. The patients were divided into the long-term (>6 months) and short-term DAPT group (≤ 6 months). The primary end point was major adverse cardiovascular events (MACE) from 6 months after the index date. The secondary outcomes were all-cause mortality and Thrombolysis in Myocardial Infarction (TIMI) bleeding.<h4>Results</h4>A total of 1899 patients were enrolled; of them, 1112 and 787 were assigned to the long-term and short-term DAPT groups, respectively. Long-term DAPT was associated with similar risk of MACE (HR: 1.05, 95% CI: 0.65-1.70, P = 0.83) compare with short-term DAPT. Different CKD risk did not modify the risk of MACE. There was also no significant difference in all-cause mortality (HR: 1.10, 95% CI: 0.75-1.61, P = 0.63) and TIMI bleeding (HR 1.19, 95% CI: 0.86-1.63, P = 0.30) between groups.<h4>Conclusions</h4>Among patients with CKD and coronary stenting, we found that long-term and short-term DAPT tied on the risk of MACE, all-cause mortality and TIMI bleeding.
format	article
author	Chih-Chin Kao Mai-Szu Wu Ming-Tsang Chuang Yi-Cheng Lin Chun-Yao Huang Wei-Chiao Chang Chih-Wei Chen Tzu-Hao Chang
author_facet	Chih-Chin Kao Mai-Szu Wu Ming-Tsang Chuang Yi-Cheng Lin Chun-Yao Huang Wei-Chiao Chang Chih-Wei Chen Tzu-Hao Chang
author_sort	Chih-Chin Kao
title	Investigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.
title_short	Investigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.
title_full	Investigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.
title_fullStr	Investigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.
title_full_unstemmed	Investigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.
title_sort	investigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/afda8bca7355416db224ec85ebd112aa
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Investigation of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease.

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