Optimizing the Duration of Dual Antiplatelet Therapy After Implantation of Drug-eluting Coronary Stents
摘要Percutaneous coronary intervention (PCI) with implantation of drug-eluting stents (DESs) has become the standard of care for coronary artery disease and gives a great impetus to device industry[1,2] In 2013,approximately half million patients with coronary artery disease underwent PCI in China,with a penetration rate of DES reaching beyond 95%.[3] The use of DES including domestic ones is highly effective in preventing coronary restenosis,but there is a collateral cost to be borne in terms of delayed healing or re-endothelialization of the stented arterial segment and risk of stent thrombosis.[4] Therefore,dual antiplatelet therapy (DAPT) with aspirin and P2Y 12 receptor antagonist for at least 12 months after DES implantation is strongly recommended by Chinese guidelines on PCI.[5] Since prolonged DAPT may increase major bleeding and subsequent mortality,balancing ischemia (or thrombotic events) and bleeding with DAPT is always important for improving overall clinical outcome after DES-based PCI.
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