Ozaki Yuichi, Garcia-Garcia Hector M, Mintz Gary S, Waksman Ron
Section of Interventional Cardiology, MedStar Washington Hospital Center , Washington, DC, USA.
Clinical Trials Center, Cardiovascular Research Foundation , New York, NY, USA.
Expert Rev Cardiovasc Ther. 2020 May;18(5):261-267. doi: 10.1080/14779072.2020.1759421. Epub 2020 May 4.
Dual antiplatelet therapy (DAPT) is required for coronary artery disease treated with drug-eluting stents (DES) implantation. Shortening DAPT duration would be beneficial for patients with high bleeding risk.
Early healing patterns, especially stent strut coverage, assessed by optical coherence tomography (OCT) as a surrogate of neointima have been investigated to make decisions on whether short DAPT would be a safe alternative. This review evaluates the OCT evidence (i.e. neointimal coverage of stent struts within 3 months) for shortening DAPT duration after DES implantation.
Shortening DAPT (i.e. within 3 months) duration after DES implantation might reduce complications including bleeding without increasing stent thrombosis. However, the optimal duration of DAPT after DES implantation is under discussion. Long-term assessment of short DAPT is required for the decision of the new guidelines regarding the recommended duration of DAPT.
药物洗脱支架（DES）植入治疗冠状动脉疾病需要双重抗血小板治疗（DAPT）。缩短DAPT疗程对高出血风险患者有益。
通过光学相干断层扫描（OCT）评估早期愈合模式，特别是支架小梁覆盖情况，作为新生内膜的替代指标，已被用于决定短期DAPT是否为安全选择。本综述评估了DES植入后缩短DAPT疗程的OCT证据（即3个月内支架小梁的新生内膜覆盖情况）。
DES植入后缩短DAPT疗程（即3个月内）可能会减少包括出血在内的并发症，而不会增加支架血栓形成。然而，DES植入后DAPT的最佳疗程仍在讨论中。新指南中关于推荐DAPT疗程的决策需要对短期DAPT进行长期评估。
