Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Apr;40(2):327-336.
doi: 10.1007/s12928-025-01087-9. Epub 2025 Jan 17.

Impact of procedural and patient-related risks on 1-year outcomes for patients treated with 1-month dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy after biodegradable-polymer drug-eluting stent implantation

Ryutaro Shimada  1 , Masaru Ishida  2 , Fumiaki Takahashi  3 , Masanobu Niiyama  4 , Takenori Ishisone  1   5 , Yuki Matsumoto  6   7 , Yuya Taguchi  1   8 , Takuya Osaki  7 , Osamu Nishiyama  9 , Hiroshi Endo  10 , Ryohei Sakamoto  11 , Kentaro Tanaka  12 , Yorihiko Koeda  1 , Takumi Kimura  1 , Iwao Goto  1 , Ryo Ninomiya  1   6 , Wataru Sasaki  1 , Kaho Shimada  1 , Tomonori Itoh  1 , Yoshihiro Morino  1 ; REIWA investigators
Affiliations
Multicenter Study

Impact of procedural and patient-related risks on 1-year outcomes for patients treated with 1-month dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy after biodegradable-polymer drug-eluting stent implantation

Ryutaro Shimada et al. Cardiovasc Interv Ther. 2025 Apr.

Abstract

In clinical practice, the impact of procedural or patient-related risk factors on 1-year clinical outcomes in patients receiving 1-month of dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy after contemporary percutaneous coronary intervention (PCI) remains unclear. Using data from the multi-center REIWA registry which included patients treated with thin-strut biodegradable polymer drug-eluting stent (BP-DES) and 1-month DAPT followed by P2Y12 inhibitor monotherapy, we assessed the primary endpoint (a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, ischemic or hemorrhagic stroke, and major or minor bleeding) in patients with and without procedural (treatment of three vessels, three or more lesions, three or more stents, bifurcation with two stents, long stenting, and target of chronic total occlusion) and patient-related risk factor (renal insufficiency, anemia, peripheral vascular disease, prior or current history of heart failure and advanced age of ≥ 75 years). Among the 1,202 patients who underwent complete revascularization by PCI, 276 (23.0%) had at least one procedural factor and 510 (42.4%) had one or more patient-related risks. At the 1-year follow-up, there were no statistical differences in the primary endpoint between patients with and without procedural risk factors. However, patients with patient-related risk factors, particularly those with renal insufficiency, anemia, heart failure, or advanced age, had a significantly higher incidence of the primary endpoint. In conclusion, patient-related risk factors significantly affected the 1-year clinical outcomes after BP-DES implantation and 1-month DAPT followed by P2Y12 inhibitor monotherapy, whereas procedural risk factors had little impact.

Keywords: Coronary artery disease; Drug-eluting stent; Dual antiplatelet therapy; Percutaneous coronary intervention; Risk factor.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: Masaru Ishida has received lecture honoraria (BIOTRONIK Japan, Boston Scientific Japan, Daiichi-Sankyo, FUKUDA DENSHI, Japan Lifeline, Terumo Corporation). Takenori Ishisone has received lecture honoraria (Boston Scientific Japan, Daiichi-Sankyo, Japan Lifeline, Orbus Neich). Tomonori Itoh has received lecture honoraria (Daiichi Sankyo, Novartis). Yoshihiro Morino has received unrestricted research grants (Boston Scientific Japan, Japan Lifeline, Terumo) and lecture honoraria (Boston Scientific Japan, Daiichi-Sankyo, Terumo). None of the other authors have any conflicts of interest. IRB information: Iwate Medical University, IRB Committee reference No. MH2019-042.

Similar articles

See all similar articles

References

    1. Tada T, et al. Duration of dual antiplatelet therapy and long-term clinical outcome after coronary drug-eluting stent implantation: landmark analyses from the CREDO-Kyoto PCI/CABG Registry Cohort-2. Circ Cardiovasc Interv. 2012;5(3):381–91. - DOI - PubMed
    1. Giustino G, et al. Efficacy and safety of dual antiplatelet therapy after complex PCI. J Am Coll Cardiol. 2016;68(17):1851–64. - DOI - PubMed
    1. Valgimigli M, et al. Duration of antiplatelet therapy after complex percutaneous coronary intervention in patients at high bleeding risk: a MASTER DAPT trial sub-analysis. Eur Heart J. 2022;43(33):3100–14. - DOI - PubMed
    1. Gragnano F, et al. P2Y(12) inhibitor monotherapy or dual antiplatelet therapy after complex percutaneous coronary interventions. J Am Coll Cardiol. 2023;81(6):537–52. - DOI - PubMed
    1. Baber U, et al. Coronary thrombosis and major bleeding after PCI With drug-eluting stents: risk scores from PARIS. J Am Coll Cardiol. 2016;67(19):2224–34. - DOI - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources