Clinical outcomes of prolonged dual antiplatelet therapy after coronary drug- eluting stent implantation in dialysis patients
Clinical Kidney Journal May 06, 2020
Park S, Kim Y, Jo HA, et al. - In view of the observation that end-stage renal disease yields susceptibility to both ischemia and bleeding and the reported benefits of prolonged dual antiplatelet therapy (DAPT) > 12 months in chronic kidney disease, researchers here examined the effectiveness and safety of prolonged DAPT in dialysis patients with higher cardiovascular risks. They conducted a nationwide population-based study including dialysis patients who underwent drug-eluting stent (DES) implantation from 2008 to 2015. They performed landmark analyses including free-of-event participants at 12 (n = 2,246), 15 (n = 1,925) and 18 months (n = 1,692) after DES implantation, to compare continued DAPT with discontinued DAPT. Depending on landmarks, mean follow-up periods of 278.3–292.4 days was reported. Overall, far lower incidences of major bleeding vs those of MACE were observed. Outcomes suggest reduction in MACE in correlation with receiving prolonged DAPT with no significant increase in major bleeding in patients who were event-free at 12 months after DES implantation. While deciding on DAPT duration, they recommend considering prolonged DAPT in dialysis patients.
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