Age and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: a post hoc analysis of the randomized PATH-PCI trial
It is particularly important to establish more effective and safer antiplatelet treatment strategies according to age. The present subanalysis of the PATH-PCI trial was to determine the safety and efficacy of any dual-antiplatelet therapy (DAPT) strategy in different age groups. We randomized 2285 c...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2023-12-01
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| Series: | Platelets |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/09537104.2023.2206915 |
| _version_ | 1797684074261774336 |
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| author | Ying Pan Ting-Ting Wu Xian-Geng Hou Yi Yang Chang-Jiang Deng Shun Wang Ying-Ying Zheng Xiang Xie |
| author_facet | Ying Pan Ting-Ting Wu Xian-Geng Hou Yi Yang Chang-Jiang Deng Shun Wang Ying-Ying Zheng Xiang Xie |
| author_sort | Ying Pan |
| collection | DOAJ |
| description | It is particularly important to establish more effective and safer antiplatelet treatment strategies according to age. The present subanalysis of the PATH-PCI trial was to determine the safety and efficacy of any dual-antiplatelet therapy (DAPT) strategy in different age groups. We randomized 2285 chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI) into a standard group or a personalized group from December 2016 to February 2018. The personalized group received personalized antiplatelet therapy (PAT) based on a novel platelet function test (PFT). The standard group received standard antiplatelet therapy (SAT). Then, all patients were divided according to age (under the age of 65 years and aged 65 years or over) to investigate the association and interaction of age on clinical outcomes at 180 days. In the patients under the age of 65 years, the incidence of NACEs was decreased in the personalized group compared to the standard group (5.1% vs. 8.8%, HR: 0.603, 95% CI: 0.409–0.888, P = .010). The rates of MACCEs (3.3% vs. 7.7%, HR: 0.450, 95% CI: 0.285–0.712, P = .001), MACEs (2.2% vs. 5.4%, HR: 0.423, 95% CI: 0.243–0.738, P = .002) also decreased. We did not find a significant difference in bleeding between the groups. In the patients aged 65 years or over, no difference in the primary endpoint was found (4.9% vs. 4.2%, P = .702), and comparable rates of survival were observed with the two strategies (all Ps > 0.05). The present study shows that PAT according to PFT was comparable to SAT at the 180-day follow-up for both ischemic and bleeding endpoints in CCS patients aged 65 years or over who underwent PCI. In patients under the age of 65 years, PAT can reduce ischemic events but does not increase bleeding, and it is an effective and safe treatment strategy. It may be necessary for young CCS patients after PCI to undergo PAT early after PCI. |
| first_indexed | 2024-03-12T00:25:11Z |
| format | Article |
| id | doaj.art-6fb6258c090844d39dc0bea01ab90b37 |
| institution | Directory Open Access Journal |
| issn | 0953-7104 1369-1635 |
| language | English |
| last_indexed | 2024-03-12T00:25:11Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Platelets |
| spelling | doaj.art-6fb6258c090844d39dc0bea01ab90b372023-09-15T10:38:12ZengTaylor & Francis GroupPlatelets0953-71041369-16352023-12-0134110.1080/09537104.2023.22069152206915Age and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: a post hoc analysis of the randomized PATH-PCI trialYing Pan0Ting-Ting Wu1Xian-Geng Hou2Yi Yang3Chang-Jiang Deng4Shun Wang5Ying-Ying Zheng6Xiang Xie7Xinjiang Medical University Affiliated First HospitalXinjiang Medical University Affiliated First HospitalXinjiang Medical University Affiliated First HospitalXinjiang Medical University Affiliated First HospitalXinjiang Medical University Affiliated First HospitalXinjiang Medical University Affiliated First HospitalXinjiang Medical University Affiliated First HospitalXinjiang Medical University Affiliated First HospitalIt is particularly important to establish more effective and safer antiplatelet treatment strategies according to age. The present subanalysis of the PATH-PCI trial was to determine the safety and efficacy of any dual-antiplatelet therapy (DAPT) strategy in different age groups. We randomized 2285 chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI) into a standard group or a personalized group from December 2016 to February 2018. The personalized group received personalized antiplatelet therapy (PAT) based on a novel platelet function test (PFT). The standard group received standard antiplatelet therapy (SAT). Then, all patients were divided according to age (under the age of 65 years and aged 65 years or over) to investigate the association and interaction of age on clinical outcomes at 180 days. In the patients under the age of 65 years, the incidence of NACEs was decreased in the personalized group compared to the standard group (5.1% vs. 8.8%, HR: 0.603, 95% CI: 0.409–0.888, P = .010). The rates of MACCEs (3.3% vs. 7.7%, HR: 0.450, 95% CI: 0.285–0.712, P = .001), MACEs (2.2% vs. 5.4%, HR: 0.423, 95% CI: 0.243–0.738, P = .002) also decreased. We did not find a significant difference in bleeding between the groups. In the patients aged 65 years or over, no difference in the primary endpoint was found (4.9% vs. 4.2%, P = .702), and comparable rates of survival were observed with the two strategies (all Ps > 0.05). The present study shows that PAT according to PFT was comparable to SAT at the 180-day follow-up for both ischemic and bleeding endpoints in CCS patients aged 65 years or over who underwent PCI. In patients under the age of 65 years, PAT can reduce ischemic events but does not increase bleeding, and it is an effective and safe treatment strategy. It may be necessary for young CCS patients after PCI to undergo PAT early after PCI.http://dx.doi.org/10.1080/09537104.2023.2206915ageantiplateletchronic coronary syndromemajor adverse cardiovascular and cerebrovascular eventsmajor adverse cardiovascular events |
| spellingShingle | Ying Pan Ting-Ting Wu Xian-Geng Hou Yi Yang Chang-Jiang Deng Shun Wang Ying-Ying Zheng Xiang Xie Age and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: a post hoc analysis of the randomized PATH-PCI trial Platelets age antiplatelet chronic coronary syndrome major adverse cardiovascular and cerebrovascular events major adverse cardiovascular events |
| title | Age and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: a post hoc analysis of the randomized PATH-PCI trial |
| title_full | Age and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: a post hoc analysis of the randomized PATH-PCI trial |
| title_fullStr | Age and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: a post hoc analysis of the randomized PATH-PCI trial |
| title_full_unstemmed | Age and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: a post hoc analysis of the randomized PATH-PCI trial |
| title_short | Age and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients: a post hoc analysis of the randomized PATH-PCI trial |
| title_sort | age and outcomes following personalized antiplatelet therapy in chronic coronary syndrome patients a post hoc analysis of the randomized path pci trial |
| topic | age antiplatelet chronic coronary syndrome major adverse cardiovascular and cerebrovascular events major adverse cardiovascular events |
| url | http://dx.doi.org/10.1080/09537104.2023.2206915 |
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