title: Immunochemical fecal occult blood tests predict dual antiplatelet therapy discontinuation after coronary stenting.
abstract: OBJECTIVE
  The discontinuation of dual antiplatelet therapy (DAPT) increases the risk of stent thrombosis after coronary stenting. Some patients must discontinue DAPT due to gastrointestinal (GI) tract disease; however, the type of examination that is most useful for detecting GI tract diseases has not been fully evaluated. The purpose of this study was to clarify whether the immunochemical fecal occult blood test (iFOBT) can be used to predict GI tract disease-related DAPT discontinuation following stent implantation in patients with coronary artery disease.
  
  
  METHODS
  A total of 181 consecutive DAPT-naïve patients who underwent coronary stenting were divided into two groups according to the results of iFOBTs: a positive iFOBT group (n=32) and a negative iFOBT group (n=149). During the 12-month follow-up period, the DAPT discontinuation rate was lower in the negative iFOBT group than in the positive iFOBT group (3.4 vs. 18.8%, p=0.005). Kaplan-Meier event-free curves showed that the DAPT discontinuation rate in the negative iFOBT group was lower than that observed in the positive iFOBT group (log-rank test: p=0.001). Logistic and Cox regression analyses showed that a positive iFOBT result was the strongest predictor of the risk of DAPT discontinuation after coronary stenting.
  
  
  CONCLUSIONS
  A positive iFOBT result is associated with DAPT discontinuation following coronary stenting.
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Ikeda
authors.forename: Takashi
authors.initials: T
authors.lastname: Koyama
authors.forename: Masaru
authors.initials: M
authors.lastname: Ishida
authors.forename: Megumi
authors.initials: M
authors.lastname: Okawa
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Oguma
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Terata
authors.forename: Kenji
authors.initials: K
authors.lastname: Iino
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kosaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000378:metabolism / Q000601:surgery*; D023903:Coronary Restenosis / Q000517:prevention & control; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors