Dual Antiplatelet Therapy for 3 or 12 Months in Patients with Non-ST-elevation MI/Unstable Angina or ST-elevation MI: Analysis of the REDUCE Trial-Reference-Cited by-同舟云学术

Dual Antiplatelet Therapy for 3 or 12 Months in Patients with Non-ST-elevation MI/Unstable Angina or ST-elevation MI: Analysis of the REDUCE Trial

Published:2022-07-29 Issue: Volume:1 Page:
ISSN:2754-0650
Container-title:Journal of Asian Pacific Society of Cardiology
language:en
Short-container-title:J Asian Pac Soc Cardiol

Author:

Wan Ahmad Wan Azman¹^ORCID,Benit Edouard²^ORCID,Legrand Victor M³^ORCID,Yahya Achmad Fauzi⁴,Tan Huay Cheem⁵^ORCID,Rifqi Sodiqur⁶,Abdul Kader Muhamad Ali SK⁷^ORCID,Pironi Bruno⁸,de Winter Robert J⁹,Tam Chor-Cheung Frankie¹⁰,Ligtenberg Eric¹¹,De Luca Giuseppe¹²,Suryapranata Harry¹³

Affiliation:

1. Cardiology Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia

2. Department of Invasive and Interventional Cardiology, Jessa Ziekenhuis, Hasselt, Belgium

3. Service de Cardiologie, University Hospital of Liège, Liège, Belgium

4. Department of Cardiology and Vascular Medicine, Hasan Sadikin Hospital, Jawa Barat, Indonesia

5. Department of Cardiology, National University Heart Centre, Singapore

6. Department of Cardiology and Vascular Medicine, Dr Kariadi Central General Hospital- Semarang, Jawa Tengah, Indonesia

7. Cardiology Department, Hospital Pulau Pinang, George Town, Malaysia

8. Department of Cardiology, Ospedale Madre Giuseppina Vannini, Rome, Italy

9. Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, the Netherlands

10. Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong, China

11. OrbusNeich Medical, Hoevelaken, the Netherlands

12. Department of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy

13. Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands

Abstract

Background: The aim of this subanalysis of the REDUCE (Short-term Dual Antiplatelet Therapy in Patients with ACS Treated with the COMBO Dual-therapy Stent) trial was to evaluate differences between non-ST-elevation MI/unstable angina (NSTEMI/UA) patients and ST-elevation MI (STEMI) patients in terms of patient characteristics, procedures and outcomes. Methods: In the REDUCE trial, 1,496 acute coronary syndrome patients undergoing successful COMBO stent implantation were randomised to 3 or 12 months of dual antiplatelet therapy (DAPT) treatment. In total, 789 (52.8%) patients had NSTEMI/UA and 706 (47.2%) had STEMI. For this analysis, NSTEMI/UA patients (n=789) were compared with STEMI patients (n=706). Results: In the analysis of the NSTEMI/UA and STEMI cohorts comparing 3-month DAPT (751 patients) and 12-month DAPT treatment (745 patients) there were no statistically significant differences in the primary endpoints of all-cause mortality, MI, stent thrombosis, stroke, target vessel revascularisation or bleeding (Bleeding Academic Research Consortium [BARC] II, III, V) at 360 and 720 days between the two cohorts. Comparing the overall primary endpoints in the NSTEMI/UA cohort, 3-month DAPT was better than 12-month DAPT (9.6% versus 10.0% at 360 days and 12.1% versus 15.0% at 720 days). In the STEMI cohort, 12-month DAPT was better than 3-month DAPT (8.4% versus 11.0% at 720 days). Conclusion: For NSTEMI/UA patients, a numerically lower occurrence of outcomes was observed with 3-month DAPT at 360 and 720 days, whereas for STEMI patients, 12-month DAPT appeared to be better at 720 days. NSTEMI patients seemed to have less favourable long-term outcomes than STEMI patients in this subanalysis. Further adequately powered randomised trials are needed to confirm the findings.

Publisher

Radcliffe Media Media Ltd

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