Comparison of the 9-Month Intrastent Condition and 30-Month Clinical Outcomes After Resolute Zotarolimus-Eluting Stent Implantation Between Standard-Duration and 1-Month Dual Antiplatelet Therapy Followed by Prasugrel Monotherapy

Figures

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  Figure 1.. Optical coherence tomography findings. (A) Uncovered struts (arrowheads) are observed between 2 and 3 o’clock. (B) Malapposed struts (arrowheads) are observed between 1 and 6 o’clock. (C) Abnormal intrastent tissue (arrowhead) is observed at 7 o’clock.

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  Figure 2.. Patient flowchart. Of the 120 patients who underwent Resolute zotarolimus-eluting stent (R-ZES) implantation by optical coherence tomography (OCT) guidance, 63 patients were assigned to receive standard-duration dual antiplatelet therapy (DAPT) and 57 were assigned to receive the 1-month DAPT followed by prasugrel (1M). However, 16 and 11 patients in the standard and 1M groups, respectively, were excluded, leaving 47 patients (n=55 stents) in the standard group and 46 patients (n=54 stents) in the 1M group. CAG, coronary angiography.

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  Figure 3.. Comparison of the rate of dual antiplatelet therapy (DAPT) administration between patients receiving standard-duration DAPT and those receiving 1-month DAPT followed by prasugrel (1M). In the 1M group, aspirin was stopped at 1 month after stent implantation and prasugrel was continued. In the standard group, DAPT was continued until at least the 9-month follow-up coronary angiography examination. Subsequent antiplatelet therapy was administered at the discretion of the attending physician. Finally, 36.2% of the patients in the standard group received DAPT.

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  Figure 4.. Comparison of (A) platelet reaction units (PRU) and (B) aspirin reaction units (ARU) between patients receiving standard-duration dual antiplatelet therapy (DAPT) and those receiving 1-month DAPT followed by prasugrel (1M) at the index procedure and after 1, 3, and 9 months.

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  Figure 5.. Results of Kaplan-Meier analysis. (A) Kaplan-Meier analysis of composite endpoints, including major adverse cardiovascular and cerebrovascular events (MACCE) and bleeding events, between patients receiving standard-duration dual antiplatelet therapy (DAPT) and those receiving 1-month DAPT followed by prasugrel (1M). (B) Comparison of MACCE between the 2 groups. (C) Comparison of bleeding events between the 2 groups. The incidence of bleeding events within the first 30 days was similar between the 2 groups, but the incidence from 30 days to 30 months tended to be lower in the 1M than standard group (18.5% vs. 23.8%; hazard ratio 0.66; 95% confidence interval 0.26–1.65).