Long-term Effects of P2Y12 Inhibitor Monotherapy After Percutaneous Coronary Intervention 3-Year Follow-up of the SMART-CHOICE Randomized Clinical Trial
DC Field | Value | Language |
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dc.contributor.author | Choi, Ki Hong | - |
dc.contributor.author | Park, Yong Hwan | - |
dc.contributor.author | Song, Young Bin | - |
dc.contributor.author | Park, Taek Kyu | - |
dc.contributor.author | Lee, Joo Myung | - |
dc.contributor.author | Yang, Jeong Hoon | - |
dc.contributor.author | Choi, Jin-Ho | - |
dc.contributor.author | Choi, Seung-Hyuk | - |
dc.contributor.author | Oh, Ju-Hyeon | - |
dc.contributor.author | Chun, Woo Jung | - |
dc.contributor.author | Jang, Woo Jin | - |
dc.contributor.author | Im, Eul-Soon | - |
dc.contributor.author | Jeong, Jin-Ok | - |
dc.contributor.author | Cho, Byung Ryul | - |
dc.contributor.author | Oh, Seok Kyu | - |
dc.contributor.author | Yun, Kyeong Ho | - |
dc.contributor.author | Cho, Deok-Kyu | - |
dc.contributor.author | Lee, Jong-Young | - |
dc.contributor.author | Koh, Young-Youp | - |
dc.contributor.author | Bae, Jang-Whan | - |
dc.contributor.author | Choi, Jae Woong | - |
dc.contributor.author | Lee, Wang Soo | - |
dc.contributor.author | Yoon, Hyuck Jun | - |
dc.contributor.author | Lee, Seung Uk | - |
dc.contributor.author | Cho, Jang Hyun | - |
dc.contributor.author | Choi, Woong Gil | - |
dc.contributor.author | Rha, Seung-Woon | - |
dc.contributor.author | Gwon, Hyeon-Cheol | - |
dc.contributor.author | Hahn, Joo-Yong | - |
dc.contributor.author | SMART-CHOICE Investigators | - |
dc.date.accessioned | 2022-10-18T02:40:36Z | - |
dc.date.available | 2022-10-18T02:40:36Z | - |
dc.date.issued | 2022-11 | - |
dc.identifier.issn | 2380-6583 | - |
dc.identifier.issn | 2380-6591 | - |
dc.identifier.uri | https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61633 | - |
dc.description.abstract | Importance Although P2Y12 inhibitor monotherapy after a minimum period of dual antiplatelet therapy (DAPT) is a well-known way to reduce the risk of bleeding after percutaneous coronary intervention (PCI), data comparing long-term clinical outcomes between P2Y12 inhibitor monotherapy and extended DAPT in patients undergoing PCI have been unavailable. Objective To identify the long-term safety and efficacy of P2Y12 inhibitor monotherapy following 3 months of DAPT after PCI. Design, Setting, and Participants The Smart Angioplasty Research Team: Comparison Between P2Y12 Antagonist Monotherapy and Dual Antiplatelet Therapy in Patients Undergoing Implantation of Coronary Drug-Eluting Stents (SMART-CHOICE) trial was an open-label, noninferiority, randomized clinical trial, enrolling patients who underwent PCI with drug-eluting stent at 33 hospitals in Korea from March 2014 through July 2017. Clinical follow-up was extended to 3 years and completed in August 2020. Interventions Patients were randomly assigned to either P2Y12 inhibitor monotherapy after 3 months of DAPT or DAPT for 12 months or longer. Main Outcomes and Measures The primary end point was major adverse cardiac and cerebrovascular events (a composite of all-cause death, myocardial infarction, or stroke) at 3 years. The secondary end points included the components of the primary end point, bleeding (defined as Bleeding Academic Research Consortium [BARC] types 2-5), and major bleeding (BARC types 3-5). Results In total, 2993 patients were randomly assigned to receive P2Y12 inhibitor monotherapy after 3 months of DAPT (1495 patients [50%]; mean [SD] age, 64.6 [10.7] years; 1087 [72.7%] male) or prolonged DAPT (1498 patients [50%]; mean [SD] age, 64.6 [10.7] years; 1111 [74.2%] male) after PCI. At 3 years, the primary end point occurred in 87 individuals (6.3%) in the P2Y12 inhibitor monotherapy group and 83 (6.1%) in the prolonged DAPT group (hazard ratio [HR], 1.06 [95% CI, 0.79-1.44]; P = .69). P2Y12 inhibitor monotherapy significantly reduced the risk of bleeding (BARC types 2-5: 112 [3.2%] vs 44 [8.2%]; HR, 0.39 [95% CI, 0.28-0.55]; P < .001) and major bleeding (BARC types 3-5; 17 [1.2%] vs 31 [2.4%]; HR, 0.56 [95% CI, 0.31-0.99]; P = .048), compared with prolonged DAPT. The landmark analyses between 3 months and 3 years and per-protocol analyses showed consistent results. Conclusions and Relevance Among patients who underwent PCI and completed 3-month DAPT, P2Y12 inhibitor monotherapy was associated with a lower risk of clinically relevant major bleeding than prolonged DAPT. Although the 3-year risk of ischemic cardiovascular events was comparable between the 2 groups, this result should be interpreted with caution owing to the limited number of events and sample size. Trial Registration ClinicalTrials.gov Identifier: NCT02079194 | - |
dc.format.extent | 9 | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | American Medical Association | - |
dc.title | Long-term Effects of P2Y12 Inhibitor Monotherapy After Percutaneous Coronary Intervention 3-Year Follow-up of the SMART-CHOICE Randomized Clinical Trial | - |
dc.type | Article | - |
dc.publisher.location | 미국 | - |
dc.identifier.doi | 10.1001/jamacardio.2022.3203 | - |
dc.identifier.scopusid | 2-s2.0-85139696607 | - |
dc.identifier.wosid | 000862049300003 | - |
dc.identifier.bibliographicCitation | JAMA cardiology, v.7, no.11, pp 1100 - 1108 | - |
dc.citation.title | JAMA cardiology | - |
dc.citation.volume | 7 | - |
dc.citation.number | 11 | - |
dc.citation.startPage | 1100 | - |
dc.citation.endPage | 1108 | - |
dc.type.docType | Article; Early Access | - |
dc.description.isOpenAccess | N | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Cardiovascular System & Cardiology | - |
dc.relation.journalWebOfScienceCategory | Cardiac & Cardiovascular Systems | - |
dc.subject.keywordPlus | DUAL-ANTIPLATELET THERAPY | - |
dc.subject.keywordPlus | DRUG-ELUTING STENTS | - |
dc.subject.keywordPlus | 2011 ACCF/AHA/SCAI GUIDELINE | - |
dc.subject.keywordPlus | ASSOCIATION TASK-FORCE | - |
dc.subject.keywordPlus | FOCUSED UPDATE | - |
dc.subject.keywordPlus | CARDIOVASCULAR EVENTS | - |
dc.subject.keywordPlus | ACC/AHA GUIDELINE | - |
dc.subject.keywordPlus | AMERICAN-COLLEGE | - |
dc.subject.keywordPlus | ARTERY-DISEASE | - |
dc.subject.keywordPlus | IMPLANTATION | - |
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