Duration of dual antiplatelet therapy in elective drug coated balloon angioplasty

Corballis, Natasha, Wickramarachchi, Upul, Vassiliou, Vassilios and Eccleshall, Simon C. (2019) Duration of dual antiplatelet therapy in elective drug coated balloon angioplasty. Catheterization and Cardiovascular Interventions. ISSN 1522-1946

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Objectives: We sought to answer whether one-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 one-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 was conducted from January 1st, 2012 to March 31st, 2017 from a high-volume, tertiary PCI cente. All patients who received a one-month duration of DAPT after elective DCB angioplasty were included. We identified a primary composite outcome of cardiac death, myocardial infarction and target lesion revascularisation at 6-months. Results: This included 303 patients (78.5% male) with a mean age of 67±12.5. This incorporated 86.1% de novo lesions and 56.5% non-small (3mm 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%) non-target vessel MIs and one (0.3%) non-cardiac 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 non-small coronary arteries treated with DCB-only angioplasty. A one-month duration of DAPT appears a safe and attractive option.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 27 Nov 2019 01:59
Last Modified: 11 Jun 2020 01:19
URI: https://ueaeprints.uea.ac.uk/id/eprint/73080
DOI: 10.1002/ccd.28632

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