Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.

Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing per...

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Autores principales:	Ming-Yun Ho, Po-Wei Chen, Wen-Han Feng, Chun-Hung Su, Sheng-Wei Huang, Chung-Wei Cheng, Hung-I Yeh, Ching-Pei Chen, Wei-Chun Huang, Ching-Chang Fang, Hui-Wen Lin, Sheng-Hsiang Lin, I-Chang Hsieh, Yi-Heng Li
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fc26b6d12b7e42fb819b7c9286c99d6e
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spelling	oai:doaj.org-article:fc26b6d12b7e42fb819b7c9286c99d6e2021-12-02T20:05:39ZEffect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.1932-620310.1371/journal.pone.0251109https://doaj.org/article/fc26b6d12b7e42fb819b7c9286c99d6e2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251109https://doaj.org/toc/1932-6203Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). However, it is unclear about the optimal duration of aspirin in P2Y12 inhibitor monotherapy. The purpose of this study was to evaluate the influence of aspirin treatment duration on clinical outcomes in a cohort of ACS patients with early aspirin interruption and received P2Y12 inhibitor monotherapy. From January 1, 2014 to December 31, 2018, we included 498 ACS patients (age 70.18 ± 12.84 years, 71.3% men) with aspirin stopped for various reasons before 6 months after PCI and received P2Y12 inhibitor monotherapy. The clinical outcomes between those with aspirin treatment ≤ 1 month and > 1 month were compared in 12-month follow up after PCI. Inverse probability of treatment weighting was used to balance the covariates between groups. The mean duration of aspirin treatment was 7.52 ± 8.10 days vs. 98.05 ± 56.70 days in the 2 groups (p<0.001). The primary composite endpoint of all-cause mortality, recurrent ACS or unplanned revascularization and stroke occurred in 12.6% and 14.4% in the 2 groups (adjusted HR 1.19, 95% CI 0.85-1.68). The safety outcome of BARC 3 or 5 bleeding was also similar (adjusted HR 0.69, 95% CI 0.34-1.40) between the 2 groups. In conclusion, patients with ≤ 1 month aspirin treatment had similar clinical outcomes to those with treatment > 1 month. Our results indicated that ≤ 1-month aspirin may be enough in P2Y12 inhibitor monotherapy strategy for ACS patients undergoing PCI.Ming-Yun HoPo-Wei ChenWen-Han FengChun-Hung SuSheng-Wei HuangChung-Wei ChengHung-I YehChing-Pei ChenWei-Chun HuangChing-Chang FangHui-Wen LinSheng-Hsiang LinI-Chang HsiehYi-Heng LiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251109 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ming-Yun Ho Po-Wei Chen Wen-Han Feng Chun-Hung Su Sheng-Wei Huang Chung-Wei Cheng Hung-I Yeh Ching-Pei Chen Wei-Chun Huang Ching-Chang Fang Hui-Wen Lin Sheng-Hsiang Lin I-Chang Hsieh Yi-Heng Li Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.
description	Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). However, it is unclear about the optimal duration of aspirin in P2Y12 inhibitor monotherapy. The purpose of this study was to evaluate the influence of aspirin treatment duration on clinical outcomes in a cohort of ACS patients with early aspirin interruption and received P2Y12 inhibitor monotherapy. From January 1, 2014 to December 31, 2018, we included 498 ACS patients (age 70.18 ± 12.84 years, 71.3% men) with aspirin stopped for various reasons before 6 months after PCI and received P2Y12 inhibitor monotherapy. The clinical outcomes between those with aspirin treatment ≤ 1 month and > 1 month were compared in 12-month follow up after PCI. Inverse probability of treatment weighting was used to balance the covariates between groups. The mean duration of aspirin treatment was 7.52 ± 8.10 days vs. 98.05 ± 56.70 days in the 2 groups (p<0.001). The primary composite endpoint of all-cause mortality, recurrent ACS or unplanned revascularization and stroke occurred in 12.6% and 14.4% in the 2 groups (adjusted HR 1.19, 95% CI 0.85-1.68). The safety outcome of BARC 3 or 5 bleeding was also similar (adjusted HR 0.69, 95% CI 0.34-1.40) between the 2 groups. In conclusion, patients with ≤ 1 month aspirin treatment had similar clinical outcomes to those with treatment > 1 month. Our results indicated that ≤ 1-month aspirin may be enough in P2Y12 inhibitor monotherapy strategy for ACS patients undergoing PCI.
format	article
author	Ming-Yun Ho Po-Wei Chen Wen-Han Feng Chun-Hung Su Sheng-Wei Huang Chung-Wei Cheng Hung-I Yeh Ching-Pei Chen Wei-Chun Huang Ching-Chang Fang Hui-Wen Lin Sheng-Hsiang Lin I-Chang Hsieh Yi-Heng Li
author_facet	Ming-Yun Ho Po-Wei Chen Wen-Han Feng Chun-Hung Su Sheng-Wei Huang Chung-Wei Cheng Hung-I Yeh Ching-Pei Chen Wei-Chun Huang Ching-Chang Fang Hui-Wen Lin Sheng-Hsiang Lin I-Chang Hsieh Yi-Heng Li
author_sort	Ming-Yun Ho
title	Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.
title_short	Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.
title_full	Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.
title_fullStr	Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.
title_full_unstemmed	Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.
title_sort	effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received p2y12 inhibitor monotherapy.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/fc26b6d12b7e42fb819b7c9286c99d6e
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Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.

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