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The aim of this study is to evaluate the safety of new dual antiplatelet therapy (DAPT) regimen (1-month DAPT followed by prasugrel monotherapy).
32 patients (37 stents) with stable angina who underwent Resolute zotarolimus-eluting stent (R-ZES) implantation by optical coherence tomography (OCT) guidance were enrolled. Patients were assigned to 1-month (1M-group; n=15) or standard terms of DAPT (standard-group; n=17). All patients initiated DAPT with aspirin and prasugrel before R-ZES implantation and underwent follow-up OCT at 9-12 months. In 1M-group, aspirin was discontinued 1 month later and maintained prasugrel monotherapy. All patients were measured platelet reactivity unit (PRU) at the time of stent implantation, 1, 3, and follow-up study. We evaluated major adverse cardiac events [death, myocardial infarction (MI), target lesion revascularization (TLR), stent thrombosis], bleeding events and intra-stent thrombus detected by follow-up OCT.
PRU of 1M-group was similar to a standard group and well suppressed at any points. (151.6, 162.8, 149.0, 137.6, respectively) There were no death, stent thrombosis and bleeding in the two groups. Three patients occurred TLR in the standard group, while none of the 1M-group was recognized TLR. One patient of 1M-group occurred MI at the non-target lesion. Intra-stent thrombus was almost imperceptible in both groups. [0% (0/4292 struts) in 1M-group and 0.06% (3/4317 struts) in standard-group]
This study suggested that this new DAPT regimen may provide acceptable clinical results in patients treated with R-ZES. It needs further investigation to establish the safety and efficacy of this regimen.