Aims: The long-term outcome of extended dual antiplatelet therapy after percutaneous coronary intervention (PCI) is unexplored. The purpose of the study was to evaluate the 2 year safety and efficacy of continuous dual antiplatelet treatment in patients undergoing primary PCI with paclitaxel-eluting stent (PES) for acute ST segment elevation myocardial infarction (STEMI).Methods and results: A series of 145 consecutive patients with STEMI underwent primary PCI with PES. All patients received intracoronary high dose bolus and 24 hours i.v. infusion of tirofiban and were then treated with dual anti-aggregation up to 2 years. The incidence of major adverse cardiac events (MACE) was evaluated at 1 month, 1 year, and 2 years during the follow-up period. Overall, the rate of cumulative MACE detected at follow-up was 2.7%, with a 1.4% incidence of mortality and a 0.7% need for target vessel revascularisation. No major bleeding occurred during follow-up (95% C.I. 0-2.6%). Safety analysis revealed that minor bleeding occurred in 5 patients (3.4%) at the time of PCI, and that thrombocytopenia developed in 3 patients (2.1%) with the extended clopidogrel course. During the 2 year follow-up, in-stent thrombosis was seen in only 1 patient who stopped drug treatment against medical advice, but did not occur in patients who remained on dual antiplatelet therapy.Conclusions: This study shows in a 'real world' scenario that sustained dual antiplatelet therapy following primary PCI with PES in patients with STEMI is associated with very good 2 year clinical results.

Clinical results of two year dual antiplatelet therapy after primary percutaneous coronary intervention with plactitaxel-eluting stents: a single center study / Mangieri, Enrico; Tanzilli, Gaetano; Greco, Cesare; Pelliccia, F; Puddu, Paolo Emilio; Acconcia, Maria Cristina; Paravati, Vincenzo; Gaudio, Carlo. - In: EUROINTERVENTION. - ISSN 1774-024X. - STAMPA. - 3:(2007), pp. 222-227. [10.4244/EIJV3I2A38]

Clinical results of two year dual antiplatelet therapy after primary percutaneous coronary intervention with plactitaxel-eluting stents: a single center study.

MANGIERI, Enrico;TANZILLI, Gaetano;GRECO, Cesare;PELLICCIA F;PUDDU, Paolo Emilio;ACCONCIA, Maria Cristina;PARAVATI, Vincenzo;GAUDIO, Carlo
2007

Abstract

Aims: The long-term outcome of extended dual antiplatelet therapy after percutaneous coronary intervention (PCI) is unexplored. The purpose of the study was to evaluate the 2 year safety and efficacy of continuous dual antiplatelet treatment in patients undergoing primary PCI with paclitaxel-eluting stent (PES) for acute ST segment elevation myocardial infarction (STEMI).Methods and results: A series of 145 consecutive patients with STEMI underwent primary PCI with PES. All patients received intracoronary high dose bolus and 24 hours i.v. infusion of tirofiban and were then treated with dual anti-aggregation up to 2 years. The incidence of major adverse cardiac events (MACE) was evaluated at 1 month, 1 year, and 2 years during the follow-up period. Overall, the rate of cumulative MACE detected at follow-up was 2.7%, with a 1.4% incidence of mortality and a 0.7% need for target vessel revascularisation. No major bleeding occurred during follow-up (95% C.I. 0-2.6%). Safety analysis revealed that minor bleeding occurred in 5 patients (3.4%) at the time of PCI, and that thrombocytopenia developed in 3 patients (2.1%) with the extended clopidogrel course. During the 2 year follow-up, in-stent thrombosis was seen in only 1 patient who stopped drug treatment against medical advice, but did not occur in patients who remained on dual antiplatelet therapy.Conclusions: This study shows in a 'real world' scenario that sustained dual antiplatelet therapy following primary PCI with PES in patients with STEMI is associated with very good 2 year clinical results.
2007
01 Pubblicazione su rivista::01a Articolo in rivista
Clinical results of two year dual antiplatelet therapy after primary percutaneous coronary intervention with plactitaxel-eluting stents: a single center study / Mangieri, Enrico; Tanzilli, Gaetano; Greco, Cesare; Pelliccia, F; Puddu, Paolo Emilio; Acconcia, Maria Cristina; Paravati, Vincenzo; Gaudio, Carlo. - In: EUROINTERVENTION. - ISSN 1774-024X. - STAMPA. - 3:(2007), pp. 222-227. [10.4244/EIJV3I2A38]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/238320
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