title: Outcomes of Percutaneous Coronary Intervention Performed With or Without Preprocedural Dual Antiplatelet Therapy.
abstract: BACKGROUND
  Preprocedural dual antiplatelet therapy (DAPT) in percutaneous coronary interventions (PCI) has been shown to improve outcomes; however, the efficacy of the procedure and its complications in Japanese patients remain largely unexplored, so we examined the risks and benefits of DAPT before PCI and its association with in-hospital outcomes.
  
  
  RESULTS
  We analyzed data from patients who had undergone PCI at 12 centers within the metropolitan Tokyo area between September 2008 and September 2013.Our study group comprised 6,528 patients, of whom 2,079 (31.8%) were not administered preprocedural DAPT. Non-use of preprocedural DAPT was associated with death, postprocedural shock, or heart failure (odds ratio [OR]: 1.47, 95% confidence interval [CI]: 1.10-1.96, P=0.009), and postprocedural myocardial infarction (OR: 1.41, 95% CI: 1.18-1.69, P<0.001) after adjusting propensity scores for known predictors of in-hospital complications. Non-use of DAPT was not associated with procedure-related bleeding complications (OR: 0.98, 95% CI: 0.71-1.59, P=0.764).
  
  
  CONCLUSIONS
  Approximately one-third of the patients who underwent PCI did not receive preprocedural DAPT despite guideline recommendations. Our results indicate that patients undergoing PCI with DAPT have a lower risk of postprocedural cardiac events without any increased bleeding risk. Further studies are needed to implement the use of DAPT in real-world PCI.
authors.affiliation: Department of Cardiology, National Hospital Organization, Tokyo Medical Center.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Ikegami
authors.forename: Shun
authors.initials: S
authors.lastname: Kohsaka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Miyata
authors.forename: Ikuko
authors.initials: I
authors.lastname: Ueda
authors.forename: Jun
authors.initials: J
authors.lastname: Fuse
authors.forename: Munehisa
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Shiraishi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Numasawa
authors.forename: Koji
authors.initials: K
authors.lastname: Negishi
authors.forename: Iwao
authors.initials: I
authors.lastname: Nakamura
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Maekawa
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Momiyama
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D012042:Registries; D012769:Shock / Q000209:etiology / Q000401:mortality / Q000517:prevention & control
chemical_list: D010975:Platelet Aggregation Inhibitors