PDF(Pubmed)
Abstract：
UNASSIGNED: Previous trials investigating antithrombotic therapy with a direct oral anticoagulant (DOAC) and a P2Y12 inhibitor after percutaneous coronary intervention (PCI), termed dual therapy, allowed a short period of triple therapy including a DOAC, a P2Y12 inhibitor, and aspirin.
UNASSIGNED: This study aimed to determine whether discontinuation of aspirin on the first post-procedural day is safe or causes ischemic events.
UNASSIGNED: Ischemic and bleeding events during hospitalization were investigated retrospectively in all patients treated with dual therapy (DOAC + P2Y12 inhibitor, designated as group 1) or triple therapy (DOAC + P2Y12 inhibitor+aspirin, designated as group 2) from day 1 after PCI at our center.
UNASSIGNED: Of 4,564 consecutive PCI procedures, 1,059 (23.2%) had an indication for OAC. Of these, 322 met the inclusion criteria for group 1 and 62 for group 2. Baseline characteristics, CHA2DS2-VASc and HAS-BLED scores showed no relevant differences between the two groups, and the main indication for DOAC therapy was atrial fibrillation in both groups. Approximately ¼ of patients were treated for acute coronary syndrome. The mean length of post-procedural hospitalization was 2.1 ± 2.5 and 2.2 ± 3.0 days in group 1 and 2, respectively (p = 0.305). One patient per group suffered a TIA (p = 0.297). There were no other ischemic events and no statistically significant differences in bleeding events. A subgroup analysis of cases hospitalized for ≥2 post-procedural days (group 1: 100 cases, mean 4.4 ± 3.4 days vs. group 2: 25 cases, mean 4.0 ± 4.1 days) confirmed these results.
UNASSIGNED: The initiation of dual therapy and thus discontinuation of aspirin on the first postprocedural day appears to be safe with respect to short-term ischemic events in a real-world population. Almost ¼ of patients undergoing PCI have an indication for OAC, highlighting the relevance of this issue.
UNASSIGNED: This study aimed to determine whether discontinuation of aspirin on the first post-procedural day is safe or causes ischemic events.
UNASSIGNED: Ischemic and bleeding events during hospitalization were investigated retrospectively in all patients treated with dual therapy (DOAC + P2Y12 inhibitor, designated as group 1) or triple therapy (DOAC + P2Y12 inhibitor+aspirin, designated as group 2) from day 1 after PCI at our center.
UNASSIGNED: Of 4,564 consecutive PCI procedures, 1,059 (23.2%) had an indication for OAC. Of these, 322 met the inclusion criteria for group 1 and 62 for group 2. Baseline characteristics, CHA2DS2-VASc and HAS-BLED scores showed no relevant differences between the two groups, and the main indication for DOAC therapy was atrial fibrillation in both groups. Approximately ¼ of patients were treated for acute coronary syndrome. The mean length of post-procedural hospitalization was 2.1 ± 2.5 and 2.2 ± 3.0 days in group 1 and 2, respectively (p = 0.305). One patient per group suffered a TIA (p = 0.297). There were no other ischemic events and no statistically significant differences in bleeding events. A subgroup analysis of cases hospitalized for ≥2 post-procedural days (group 1: 100 cases, mean 4.4 ± 3.4 days vs. group 2: 25 cases, mean 4.0 ± 4.1 days) confirmed these results.
UNASSIGNED: The initiation of dual therapy and thus discontinuation of aspirin on the first postprocedural day appears to be safe with respect to short-term ischemic events in a real-world population. Almost ¼ of patients undergoing PCI have an indication for OAC, highlighting the relevance of this issue.
摘要：
■先前研究经皮冠状动脉介入治疗（PCI）后使用直接口服抗凝剂（DOAC）和P2Y12抑制剂进行抗血栓治疗的试验，称为双重疗法，允许短期三联疗法，包括DOAC，P2Y12抑制剂，还有阿司匹林.
■本研究旨在确定在术后第一天停用阿司匹林是安全的还是会引起缺血事件。
■对所有接受双重治疗（DOAC+P2Y12抑制剂，指定为第1组）或三联疗法（DOAC+P2Y12抑制剂+阿司匹林，从我们中心的PCI后第1天开始指定为第2组）。
■在4,564个连续的PCI程序中，1059人（23.2%）有OAC指征。其中,322符合第1组的入选标准，第2组的入选标准为62。基线特征，CHA2DS2-VASc和HAS-BLED评分两组间无相关性差异。两组DOAC治疗的主要适应症均为房颤.大约1/4的患者接受了急性冠脉综合征的治疗。第1组和第2组术后平均住院时间分别为2.1±2.5和2.2±3.0天(p=0.305)。每组一名患者患有TIA（p=0.297）。无其他缺血事件，出血事件无统计学差异。术后住院≥2天的病例的亚组分析（第1组：100例，平均4.4±3.4天vs.2组:25例,平均4.0±4.1天）证实了这些结果。
在实际人群中，在术后第一天开始双重治疗并因此停用阿司匹林似乎对短期缺血事件是安全的。近1/4接受PCI的患者有OAC指征,强调这个问题的相关性。
■本研究旨在确定在术后第一天停用阿司匹林是安全的还是会引起缺血事件。
■对所有接受双重治疗（DOAC+P2Y12抑制剂，指定为第1组）或三联疗法（DOAC+P2Y12抑制剂+阿司匹林，从我们中心的PCI后第1天开始指定为第2组）。
■在4,564个连续的PCI程序中，1059人（23.2%）有OAC指征。其中,322符合第1组的入选标准，第2组的入选标准为62。基线特征，CHA2DS2-VASc和HAS-BLED评分两组间无相关性差异。两组DOAC治疗的主要适应症均为房颤.大约1/4的患者接受了急性冠脉综合征的治疗。第1组和第2组术后平均住院时间分别为2.1±2.5和2.2±3.0天(p=0.305)。每组一名患者患有TIA（p=0.297）。无其他缺血事件，出血事件无统计学差异。术后住院≥2天的病例的亚组分析（第1组：100例，平均4.4±3.4天vs.2组:25例,平均4.0±4.1天）证实了这些结果。
在实际人群中，在术后第一天开始双重治疗并因此停用阿司匹林似乎对短期缺血事件是安全的。近1/4接受PCI的患者有OAC指征,强调这个问题的相关性。
