Vascular response to biolimus A-9 eluting stent in patients with shorter and prolonged dual antiplatelet therapy: optical coherence tomography sub-study ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-02-20

AUTHORS

Koji Kuroda, Toshiro Shinke, Hiromasa Otake, Hiroto Kinutani, Raisuke Iijima, Junya Ako, Hisayuki Okada, Yoshiaki Ito, Kenji Ando, Hitoshi Anzai, Hiroyuki Tanaka, Yasunori Ueda, Shin Takiuchi, Yasunori Nishida, Hiroshi Ohira, Katsuhiro Kawaguchi, Makoto Kadotani, Hiroyuki Niinuma, Kazuto Omiya, Takashi Morita, Kan Zen, Yoshinori Yasaka, Kenji Inoue, Sugao Ishiwata, Masahiko Ochiai, Toshimitsu Hamasaki, Kazushi Urasawa, Toru Kataoka, Minoru Yoshiyama, Kenshi Fujii, Takumi Inoue, Masahito Kawata, Hiroyoshi Yokoi, Masato Nakamura, On behalf of the NIPPON investigators

ABSTRACT

Dual antiplatelet therapy (DAPT) with thienopyridine and aspirin is the standard care for the prevention of stent thrombosis. However, the optimal duration and effect of the duration of DAPT on intra-stent thrombus (IS-Th) formation are unknown. The NIPPON study (Nobori Dual Antiplatelet Therapy as Appropriate Duration) was an open label, randomized multicenter, assessor-blinded, trial designed to demonstrate the non-inferiority of shorter (6-month) DAPT to prolonged (18-month) DAPT, after biolimus A9 eluting stent implantation in 3773 patients at 130 sites in Japan. Among them, 101 patients were randomly allocated for an optical coherence tomography (OCT) sub-study to assess the difference of local IS-Th formation between the two groups. In addition to standard OCT parameters, the number of IS-Th formed was counted in each target stent at 8 months. Baseline patient characteristics were not different between the 6- and 18-month groups. IS-Th was detected in 9.8% of the cases and the presence of IS-Th was not significantly different between the two groups (10.9% in 6-month vs. 9.1% in 12-month, P = 0.76). Furthermore, the number of IS-Th formed was not significantly different between the two groups. This OCT sub-study was in line with the main NIPPON study which demonstrated the non-inferiority of 6-month DAPT to 18-month DAPT. Shorter DAPT duration did not promote progressive IS-Th formation at the mid-term time point. More... »

PAGES

837-845

Journal

TITLE

Heart and Vessels

ISSUE

8

VOLUME

33

Author Affiliations

  • Division of Cardiovascular, Department of Cardiology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Hyogo, Japan
  • Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
  • Department of Cardiovascular Medicine, Kitasato University Hospital, Sagamihara, Japan
  • Department of Cardiology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
  • Division of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
  • Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
  • Cardiology Department, Ota Memorial Hospital, Ota, Japan
  • Department of Cardiology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
  • Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
  • Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Japan
  • Department of Cardiovascular Medicine, Takai Hospital, Tenri, Japan
  • Department of Cardiology, Edogawa Hospital, Tokyo, Japan
  • Department of Cardiology, Komaki City Hospital, Komaki, Japan
  • Department of Cardiology, Kakogawa Central City Hospital, Kakogawa, Japan
  • Department of Cardiology, St. Luke’s International Hospital, Tokyo, Japan
  • Division of Cardiology, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan
  • Division of Cardiology, Osaka General Medical Center, Osaka, Japan
  • Department of Cardiovascular Medicine, Omihachiman Community Medical Center, Omihachiman, Japan
  • Department of Cardiology, Hyogo Brain and Heart Center, Himeji, Japan
  • Department of Cardiology, Juntendo University Nerima Hospital, Tokyo, Japan
  • Division of Cardiovascular Center, Toranomon Hospital, Tokyo, Japan
  • Division of Cardiology and Cardiac Catheterization Laboratories, Showa University Northern Yokohama Hospital, Yokohama, Japan
  • Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
  • Cardiovascular Center, Tokeidai Memorial Hospital, Sapporo, Japan
  • Department of Cardiovascular Medicine, Bell Land General Hospital, Kyoto, Japan
  • Cardiovascular Medicine, Osaka City University Hospital, Osaka, Japan
  • Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan
  • Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Sumoto, Japan
  • Department of Cardiology, Akashi Medical Center, Akashi, Japan
  • Department of Cardiovascular Medicine Center, Fukuoka Sanno Hospital, Fukuoka, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00380-018-1131-7

    DOI

    http://dx.doi.org/10.1007/s00380-018-1131-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1101127321

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29464342


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