Is the duration of dual antiplatelet therapy (DAPT) excessive in post-angioplasty in chronic coronary syndrome? Data from the France-PCI registry (2014–2019)
Backgroundwhile the duration of dual antiplatelet therapy (DAPT) following coronary angioplasty for chronic coronary syndrome (CCS) recommended by the European Society of Cardiology has decreased over the last decade, little is known about the adherence to those guidelines in clinical practice in Fr...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1106503/full |
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| author | A. Mezier P. Motreff J. M. Clerc O. Bar R. Deballon T. Demicheli T. Dechery G. Souteyrand A. Py N. Lhoest T. Lhermusier B. Honton A. Gommeaux J. Jeanneteau P. Deharo H. Benamer G. Cayla R. Koning B. Pereira J. P. Collet G. Rangé |
| author_facet | A. Mezier P. Motreff J. M. Clerc O. Bar R. Deballon T. Demicheli T. Dechery G. Souteyrand A. Py N. Lhoest T. Lhermusier B. Honton A. Gommeaux J. Jeanneteau P. Deharo H. Benamer G. Cayla R. Koning B. Pereira J. P. Collet G. Rangé |
| author_sort | A. Mezier |
| collection | DOAJ |
| description | Backgroundwhile the duration of dual antiplatelet therapy (DAPT) following coronary angioplasty for chronic coronary syndrome (CCS) recommended by the European Society of Cardiology has decreased over the last decade, little is known about the adherence to those guidelines in clinical practice in France.AimTo analyze the real duration of DAPT post coronary angioplasty in CCS, as well as the factors affecting this duration.MethodsBetween 2014 and 2019, 8.836 percutaneous coronary interventions for CCS from the France-PCI registry were evaluated, with 1 year follow up, after exclusion of patients receiving oral anticoagulants, procedures performed within one year of an acute coronary syndrome, and repeat angioplasty.ResultsPost-percutaneous coronary intervention (PCI) DAPT duration was > 12 months for 53.1% of patients treated for CCS; 30.5% had a DAPT between 7 and 12 months, and 16.4% a DAPT ≤ 6 months. Patients with L-DAPT (>12 months) were at higher ischemic risk [25.0% of DAPT score ≥2 vs. 18.8% DAPT score ≥2 in S&I-DAPT group (≤12 months)]. The most commonly used P2Y12 inhibitor was clopidogrel (82.2%). The prescription of ticagrelor increased over the period.Conclusionspost-PCI DAPT duration in CCS was higher than international recommendations in the France PCI registry between 2014 and 2019. More than half of the angioplasty performed for CCS are followed by a DAPT > 12 months. Ischemic risk assessment influences the duration of DAPT. This risk is probably overestimated nowadays, leading to a prolongation of DAPT beyond the recommended durations, thus increasing the bleeding risk. |
| first_indexed | 2024-04-09T21:55:37Z |
| format | Article |
| id | doaj.art-bfddd8b330ab4fe08cc496299678a8b8 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-09T21:55:37Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-bfddd8b330ab4fe08cc496299678a8b82023-03-24T05:43:27ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-03-011010.3389/fcvm.2023.11065031106503Is the duration of dual antiplatelet therapy (DAPT) excessive in post-angioplasty in chronic coronary syndrome? Data from the France-PCI registry (2014–2019)A. Mezier0P. Motreff1J. M. Clerc2O. Bar3R. Deballon4T. Demicheli5T. Dechery6G. Souteyrand7A. Py8N. Lhoest9T. Lhermusier10B. Honton11A. Gommeaux12J. Jeanneteau13P. Deharo14H. Benamer15G. Cayla16R. Koning17B. Pereira18J. P. Collet19G. Rangé20Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, FranceCardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, FranceCardiology Department, Centre Hospitalier Universitaire de Tours, Tours, FranceCardiology Department, Nouvelle Clinique Tourangelle, Saint-Cyr-sur-Loire, FranceCardiology Department, Clinique Oréliance, Orléans, FranceCardiology Department, Les Hôpitaux de Chartres, Chartres, FranceCardiology Department, Centre Hospitalier Jacques Coeur, Bourges, FranceCardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, FranceCardiology Department, Clinique de l’Europe, Amiens, FranceCardiology Departemnt, Clinique Rhéna, Strasbourg, FranceCardiology Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France0Cardiology Department, Clinique Pasteur, Toulouse, France1Cardiology Department, Hôpital Privé de Bois-Bernard, Bois-Bernard, France2Cardiology Department, Clinique Saint Joseph, Trelaze, France3Cardiology Department, Centre Hospitalier Universitaire de la Timone, Marseille, France4Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France5Cardiology Department, Centre Hospitalier Universitaire de Nîmes, Nîmes, France6Cardiology Department, Clinique Saint Hilaire, Rouen, France7Clinical Research and Innovation Direction, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France8Cardiology Institute, Hôpital Pitié-Salpêtrière (Assistance Publique-Hôpitaux de Paris), Paris, FranceCardiology Department, Les Hôpitaux de Chartres, Chartres, FranceBackgroundwhile the duration of dual antiplatelet therapy (DAPT) following coronary angioplasty for chronic coronary syndrome (CCS) recommended by the European Society of Cardiology has decreased over the last decade, little is known about the adherence to those guidelines in clinical practice in France.AimTo analyze the real duration of DAPT post coronary angioplasty in CCS, as well as the factors affecting this duration.MethodsBetween 2014 and 2019, 8.836 percutaneous coronary interventions for CCS from the France-PCI registry were evaluated, with 1 year follow up, after exclusion of patients receiving oral anticoagulants, procedures performed within one year of an acute coronary syndrome, and repeat angioplasty.ResultsPost-percutaneous coronary intervention (PCI) DAPT duration was > 12 months for 53.1% of patients treated for CCS; 30.5% had a DAPT between 7 and 12 months, and 16.4% a DAPT ≤ 6 months. Patients with L-DAPT (>12 months) were at higher ischemic risk [25.0% of DAPT score ≥2 vs. 18.8% DAPT score ≥2 in S&I-DAPT group (≤12 months)]. The most commonly used P2Y12 inhibitor was clopidogrel (82.2%). The prescription of ticagrelor increased over the period.Conclusionspost-PCI DAPT duration in CCS was higher than international recommendations in the France PCI registry between 2014 and 2019. More than half of the angioplasty performed for CCS are followed by a DAPT > 12 months. Ischemic risk assessment influences the duration of DAPT. This risk is probably overestimated nowadays, leading to a prolongation of DAPT beyond the recommended durations, thus increasing the bleeding risk.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1106503/fullcoronary angioplastychronic coronary syndromedual antiplatelet therapybleeding riskischemic risk |
| spellingShingle | A. Mezier P. Motreff J. M. Clerc O. Bar R. Deballon T. Demicheli T. Dechery G. Souteyrand A. Py N. Lhoest T. Lhermusier B. Honton A. Gommeaux J. Jeanneteau P. Deharo H. Benamer G. Cayla R. Koning B. Pereira J. P. Collet G. Rangé Is the duration of dual antiplatelet therapy (DAPT) excessive in post-angioplasty in chronic coronary syndrome? Data from the France-PCI registry (2014–2019) Frontiers in Cardiovascular Medicine coronary angioplasty chronic coronary syndrome dual antiplatelet therapy bleeding risk ischemic risk |
| title | Is the duration of dual antiplatelet therapy (DAPT) excessive in post-angioplasty in chronic coronary syndrome? Data from the France-PCI registry (2014–2019) |
| title_full | Is the duration of dual antiplatelet therapy (DAPT) excessive in post-angioplasty in chronic coronary syndrome? Data from the France-PCI registry (2014–2019) |
| title_fullStr | Is the duration of dual antiplatelet therapy (DAPT) excessive in post-angioplasty in chronic coronary syndrome? Data from the France-PCI registry (2014–2019) |
| title_full_unstemmed | Is the duration of dual antiplatelet therapy (DAPT) excessive in post-angioplasty in chronic coronary syndrome? Data from the France-PCI registry (2014–2019) |
| title_short | Is the duration of dual antiplatelet therapy (DAPT) excessive in post-angioplasty in chronic coronary syndrome? Data from the France-PCI registry (2014–2019) |
| title_sort | is the duration of dual antiplatelet therapy dapt excessive in post angioplasty in chronic coronary syndrome data from the france pci registry 2014 2019 |
| topic | coronary angioplasty chronic coronary syndrome dual antiplatelet therapy bleeding risk ischemic risk |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1106503/full |
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