No abstract

Objectives: To explore the impact of 6-versus 12-month dual antiplatelet therapy (DAPT) on the clinical prognosis of high bleeding risk (HBR) patients. Background:The optimal DAPT duration after percutaneous coronary intervention (PCI) in HBR patients is unclear.Methods: This study is a post hoc analysis of the 4-year clinical follow-up results of the I LOVE IT 2 study. Prevalence and prognosis of HBR patients were explored, and clinical outcomes of HBR patients who underwent 6-versus 12-month DAPT were compared. The primary outcome was Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding. The secondary outcomes were BARC type 2-5 bleeding and net clinical adverse events (NACE), defined as a composite of all-cause death, myocardial infarction (MI), ischemia-driven revascularization, stroke, stent thrombosis, or any bleeding events.Results: HBR occurred in 440 of 2,737 patients (16.0%). HBR patients were associated with a higher risk of BARC type 3 or 5 bleeding (2.95 vs. 1.52%, p = .03), NACE (31.82 vs. 25.99%, p = .01), all-cause death (5.68 vs. 3.13%, p = .008) and stroke (9.09 vs. 3.83%, p < .001) than non-HBR patients at 4 years. There were no significant differences in BARC type 3 or 5 bleeding (3.07 vs. 2.76%, p = 1.00) or NACE rate (31.9 vs. 33.8%, p = .72) between patients who underwent 6-and 12-month DAPT.Conclusions: HBR patients are at a higher risk of long-term bleeding and ischemic events than non-HBR patients. The safety and efficacy of 6-and 12-month DAPT were comparable in HBR patients. K E Y W O R D S dual antiplatelet therapy, high bleeding risk, percutaneous coronary intervention, prognosis 1 | INTRODUCTION Percutaneous coronary intervention (PCI) has been established as an important procedure for the treatment of coronary heart disease (CAD). Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12inhibitor is recommended to prevent stent thrombosis and major cardiovascular adverse events (MACE) after coronary stent implantation.However, antiplatelets are associated with a risk of bleeding, and this can greatly reduce the clinical benefit of DAPT. 1-3 A variety of scoring systems have been developed to assess a patient's bleeding risk and

No abstract

No abstract