Long-term outcomes of extended DAPT in a real-life cohort of consecutive STEMI patients

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• dc.contributor.author Tizón-Marcos, Helena
• dc.contributor.author Toloba, Andrea
• dc.contributor.author Subirana Cachinero, Isaac
• dc.contributor.author Elosua Llanos, Roberto
• dc.contributor.author Marrugat de la Iglesia, Jaume
• dc.date.accessioned 2023-05-10T06:17:37Z
• dc.date.issued 2023
• dc.description.abstract Introduction and objectives: Dual antiplatelet therapy (DAPT) duration after ST-segment elevation myocardial infarction (STEMI) remains a matter of debate. Methods: We analyzed the effect of DAPT on 5-year all-cause mortality, cardiovascular mortality, and cardiovascular readmission or mortality in a cohort of 1-year survivor STEMI patients. Results: A total of 3107 patients with the diagnosis of STEMI were included: 93% of them were discharged on DAPT, a therapy that persisted in 275 high-risk patients at 5 years. Cardiovascular mortality in patients on single antiplatelet therapy vs DAPT at 5 years was 1.4% vs 3.6% (P <.01), respectively, whereas noncardiovascular mortality was 3.3% vs 5.8% (P=.049) at 5 years. Cardiovascular readmission or mortality in patients with single antiplatelet therapy vs DAPT was 11.4% vs 46.5% (P <.001). Extended DAPT was independently associated with worse 5-year all-cause mortality (HR, 2.16; 95%CI, 1.40-3.33), cardiovascular mortality (HR, 2.83; 95%CI, 1.37-5.84), and cardiovascular readmission or mortality (HR, 5.20; 95%CI, 3.96-6.82). These findings were confirmed in propensity score matching and inverse probability weighting analyses. Conclusions: Our results suggest the hypothesis that, in 1-year STEMI survivors, extending DAPT up to 5 years in high-risk patients does not improve their long-term prognosis.
• dc.format.mimetype application/pdf
• dc.identifier.citation Tizón-Marcos H, Toloba A, Subirana Cachinero I, Elosua R, Sionis A, Fernández-Avilés F, et al. Long-term outcomes of extended DAPT in a real-life cohort of consecutive STEMI patients. Rev Esp Cardiol (Engl Ed). 2023 Jul;76(7):548-54. DOI: 10.1016/j.rec.2022.12.003
• dc.identifier.doi http://dx.doi.org/10.1016/j.rec.2022.12.003
• dc.identifier.issn 1885-5857
• dc.identifier.uri http://hdl.handle.net/10230/56742
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Rev Esp Cardiol (Engl Ed). 2023 Jul;76(7):548-54
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.rec.2022.12.003
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Cohorte retrospectiva
• dc.subject.keyword Doble terapia antiagregante plaquetaria
• dc.subject.keyword Dual antiplatelet therapy
• dc.subject.keyword Infarto de miocardio con elevación del ST
• dc.subject.keyword Retrospective cohort
• dc.subject.keyword ST-elevation myocardial infarction
• dc.title Long-term outcomes of extended DAPT in a real-life cohort of consecutive STEMI patients
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion