Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy

doi:10.1371/journal.pone.0251109

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23556

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23556

Title:	Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy
Authors:	Ho, MY;Chen, PW;Feng, WH;Su, CH;Huang, SW;Cheng, CW;Yeh, HI;Chen, CP;Huang, WC;Fang, CC;Lin, HW;Lin, SH;Hsieh, IC;Li, YH
Date:	2021
Issue Date:	2022-08-05T09:39:11Z (UTC)
Publisher:	PUBLIC LIBRARY SCIENCE
ISSN:	1932-6203
Abstract:	Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). However, it is unclear about the optimal duration of aspirin in P2Y12 inhibitor monotherapy. The purpose of this study was to evaluate the influence of aspirin treatment duration on clinical outcomes in a cohort of ACS patients with early aspirin interruption and received P2Y12 inhibitor monotherapy. From January 1, 2014 to December 31, 2018, we included 498 ACS patients (age 70.18 +/- 12.84 years, 71.3% men) with aspirin stopped for various reasons before 6 months after PCI and received P2Y12 inhibitor monotherapy. The clinical outcomes between those with aspirin treatment <= 1 month and > 1 month were compared in 12-month follow up after PCI. Inverse probability of treatment weighting was used to balance the covariates between groups. The mean duration of aspirin treatment was 7.52 +/- 8.10 days vs. 98.05 +/- 56.70 days in the 2 groups (p<0.001). The primary composite endpoint of all-cause mortality, recurrent ACS or unplanned revascularization and stroke occurred in 12.6% and 14.4% in the 2 groups (adjusted HR 1.19, 95% CI 0.85-1.68). The safety outcome of BARC 3 or 5 bleeding was also similar (adjusted HR 0.69, 95% CI 0.34-1.40) between the 2 groups. In conclusion, patients with <less than or equal to> 1 month aspirin treatment had similar clinical outcomes to those with treatment > 1 month. Our results indicated that <= 1-month aspirin may be enough in P2Y12 inhibitor monotherapy strategy for ACS patients undergoing PCI.
URI:	http://dx.doi.org/10.1371/journal.pone.0251109 https://www.webofscience.com/wos/woscc/full-record/WOS:000664627300037 https://ir.csmu.edu.tw:8080/handle/310902500/23556
Relation:	PLOS ONE ,2021,v16,issue 5
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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