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ID 116292
Title Alternative
Prasugrel for PCI Patients With HBR
Author
Nakamura, Masato Toho University
Morino, Yoshihiro Iwate Medical University
Kakuta, Tsunekazu Tsuchiura Kyodo General Hospital
Hata, Yoshiki Minamino Cardiovascular Hospital
Takamisawa, Itaru Sakakibara Heart Institute
Tanabe, Kengo Mitsui Memorial Hospital
Anzai, Hitoshi Ota Memorial Hospital
Takahashi, Akihiko Sakurakai Takahashi Hospital
Kadota, Kazushige Kurashiki Central Hospital
Suzuki, Hiroshi Showa University
Okayama, Hideki Ehime Prefectural Central Hospital
Yamashita, Jun Tokyo Medical University
Akasaka, Takashi Wakayama Medical University
Yokoi, Hiroyoshi Fukuoka Sanno Hospital
Nakagami, Takuo Omihachiman Community Medical Center
Higuchi, Yoshiharu Osaka Police Hospital
Yamaguchi, Junichi Tokyo Women’s Medical University
Kimura, Takumi Iwate Prefectural Ofunato Hospital
Harada, Atsushi Daiichi Sankyo
Kuroda, Takeshi Daiichi Sankyo
Takita, Atsushi Daiichi Sankyo
Iijima, Raisuke Toho University
Murakami, Yoshitaka Toho University
Saito, Shigeru Shonan Kamakura General Hospital
Keywords
Bleeding risk
Japan
Percutaneous coronary intervention
Prasugrel
Single-antiplatelet therapy
Content Type
Journal Article
Description
Background: The risks of bleeding and cardiovascular events in high bleeding risk (HBR) Japanese patients undergoing percutaneous coronary intervention (PCI) while receiving single-antiplatelet therapy (SAPT) remains unknown. We aimed to evaluate the frequency of bleeding and cardiovascular events associated with prasugrel monotherapy after short-term dual-antiplatelet therapy (DAPT) in Japanese HBR patients after PCI.
Methods and Results: The PENDULUM mono study was a multicenter, non-interventional, prospective registry (n=1,173). The primary endpoint was the cumulative incidence of clinically relevant bleeding (CRB; Bleeding Academic Research Consortium types 2, 3, and 5) from 1 to 12 months after PCI. Secondary endpoints included major adverse cardiac and cerebrovascular events (MACCE). The proportion of patients who received prasugrel monotherapy at 12 months after PCI was 79.7%, and no cases of stent thrombosis were observed among these patients. The cumulative incidence of CRB was 3.2% from 1 to 12 months after PCI; that of MACCE was 3.8%. Severe anemia, chronic kidney disease, oral anticoagulant use at discharge, and heart failure were significantly associated with CRB.
Conclusions: Among HBR patients undergoing PCI who were not suitable for concomitant aspirin and were scheduled for prasugrel monotherapy, most patients were on prasugrel monotherapy after DAPT. Cumulative incidences of CRB and MACCE after periprocedural period were 3.2% and 3.8%, respectively, and no cases of stent thrombosis were reported. SAPT might be a suitable alternative to DAPT.
Journal Title
Circulation Journal
ISSN
13469843
13474820
NCID
AA11591968
Publisher
The Japanese Circulation Society
Volume
85
Issue
1
Start Page
27
End Page
36
Published Date
2020-12-25
Rights
This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license. https://creativecommons.org/licenses/by-nc-nd/4.0/
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DOI (Published Version)
URL ( Publisher's Version )
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language
eng
TextVersion
Publisher
departments
University Hospital