Author + information
- Tanaka Kazuki,
- Kentaro Jujo,
- Hisao Otsuki,
- Kensuke Shimazaki,
- Masashi Nakao,
- Hiroyuki Arashi,
- Junichi Yamaguchi and
- Nobuhisa Hagiwara
Introduction: The DAPT score has clinical benefits in predicting embolic and bleeding events after percutaneous coronary intervention (PCI). However to date, there has been few report testing the efficacy of DAPT score on clinical outcomes of hemodialysis patients as a population at the highest risk.
Methods: This study included 276 consecutive patients on regular hemodialysis who received thienopyridine and aspirin for at least 12 months after PCI. DAPT score in the study population was graded from -2 to 10 points at the time of PCI. During a median follow-up period of 973 days, the rate of cardiovascular (CV) death, major bleeding, and major adverse cardiac events (MACE) including CV death, target vascular revascularization and non-fatal myocardial infarction (MI) were compared between patients with high-DAPT score (≥2, n=173) and low-DAPT score (<2, n=103).
Results: High-DAPT group included younger diabetic patients with worse left ventricular ejection fraction compared to low-DAPT group. Kaplan-Meier analysis revealed that the rates of CV death and major bleeding were similar between the groups (3-year CV death: 12.5% vs. 10.6%; Major bleeding: 4.8% vs. 9.3%, Figure). In contrast, MACE rate started to differ between the groups from 9 months, and was significantly higher in high-DAPT group at 3 years after PCI (53.0% vs. 34.8%, p=0.026).
Conclusions: The DAPT score may predict long-term MACE, but not CV death or bleeding events in hemodialysis patients receiving prolonged DAPT therapy.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Optimizing the Care of ACS Patients
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1284-157
- 2017 American College of Cardiology Foundation