title: Dual Antiplatelet Therapy for 6 Months vs 12 Months After New-generation Drug-eluting Stent Implantation: Matched Analysis of ESTROFA-DAPT and ESTROFA-2.
abstract: OBJECTIVE
  The recommendation for dual antiplatelet therapy following drug-eluting stent implantation ranges from 6 months to 12 months or beyond. Recent trials have suggested the safety of a 6-month dual antiplatelet therapy regimen, yet certain caveats to these studies limit the applicability of this shorter duration dual antiplatelet therapy strategy in real world settings.
  
  
  METHODS
  A registry was constructed with consecutive recruitment of patients undergoing new-generation drug-eluting stent implantation and prescribed 6 months of dual antiplatelet therapy. Propensity score matching was undertaken with a historical cohort of patients treated with second-generation drug-eluting stents who received 12 months of dual antiplatelet therapy from the ESTROFA-2 registry. The sample size was calculated using a noninferiority basis and the primary endpoint was the combination of cardiac death, myocardial infarction, revascularization, or major bleeding at 12 months.
  
  
  RESULTS
  The analysis included 1286 patients in each group, with no significant differences in baseline characteristics. The primary endpoint occurred in 5.0% and 6.6% in the 6-month and 12-month groups, respectively (P = .001 for noninferiority). The incidence of definite or probable stent thrombosis was 0.5% and 0.7% in the 6-month and 12-month groups, respectively (P = .4). Major bleeding events were lower in the 6-month group than in the 12-month group (0.8% vs 1.4%; P = .2) CONCLUSIONS: In selected patients in this large multicenter study, the safety and efficacy of a 6-month dual antiplatelet therapy regimen after implantation of new-generation drug-eluting stents appeared to be noninferior to those of a 12-month dual antiplatelet therapy regimen.
authors.affiliation: Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander, Cantabria, Spain. Electronic address: he1thj@humv.es.
authors.forename: José M
authors.initials: JM
authors.lastname: de la Torre Hernández
authors.affiliation: Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Oteo Domínguez
authors.affiliation: Servicio de Cardiología, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Hernández
authors.affiliation: Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander, Cantabria, Spain.
authors.forename: Tamara
authors.initials: T
authors.lastname: García Camarero
authors.affiliation: Servicio de Cardiología, Hospital Mútua Terrassa, Terrassa, Barcelona, Spain.
authors.forename: Omar
authors.initials: O
authors.lastname: Abdul-Jawad Altisent
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rivero Crespo
authors.affiliation: Servicio de Cardiología, Hospital Santa Lucía, Cartagena, Murcia, Spain.
authors.forename: José D
authors.initials: JD
authors.lastname: Cascón
authors.affiliation: Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Germán
authors.initials: G
authors.lastname: Zavala
authors.affiliation: Servicio de Cardiología, Hospital Clínico, Valladolid, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Gimeno
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Arrebola Moreno
authors.affiliation: Servicio de Cardiología, Hospital de Basurto, Bilbao, Spain.
authors.forename: Leire
authors.initials: L
authors.lastname: Andraka
authors.affiliation: Servicio de Cardiología, Hospital Juan Ramón Jiménez, Huelva, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gómez Menchero
authors.affiliation: Servicio de Cardiología, Hospital Clínico, Santa Cruz de Tenerife, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Bosa
authors.affiliation: Servicio de Cardiología, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Carrillo
authors.affiliation: Servicio de Cardiología, Hospital La Paz, Madrid, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Sánchez Recalde
authors.affiliation: Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.affiliation: Servicio de Cardiología, HemoLeon, Fundación Investigación Sanitaria en León, León, Spain.
authors.forename: Armando
authors.initials: A
authors.lastname: Pérez de Prado
authors.affiliation: Servicio de Cardiología, Hospital San Juan, San Juan de Alicante, Alicante, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: López Palop
authors.affiliation: Servicio de Cardiología, Hospital Clínico, Valencia, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.affiliation: Servicio de Cardiología, Hospital Miguel Servet, Zaragoza, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Diarte de Miguel
authors.affiliation: Servicio de Cardiología, Hospital Virgen de la Victoria, Málaga, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Jiménez Navarro
authors.affiliation: Servicio de Cardiología, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Luz
authors.initials: L
authors.lastname: Muñoz
authors.affiliation: Servicio de Cardiología, Hospiten Estepona, Marbella, Málaga, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ramírez Moreno
authors.affiliation: Servicio de Cardiología, Hospital del Mar, Grupo de Investigación Biomédica en Enfermedades del Corazón, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: Tizón Marcos
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000601:surgery*; D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Antiplatelet therapy; Coronary artery disease; Drug-eluting stents; Enfermedad coronaria; Stents farmacoactivos; Tratamiento antiagregante plaquetario