Kang Jeehoon, Abdul Ghapar Abdul Kahar, Selvaraj Kamaraj, Hur Seung-Ho, Tam Chor Cheung, Jang Yangsoo, Chae In-Ho, Kandzari David E, Kirtane Ajay J, Latib Azeem, Kedhi Elvin, Lung Te-Hsin, You So-Jeong, Windecker Stephan, Stone Gregg W, Kim Hyo-Soo
Seoul National University Hospital Seoul Republic of Korea.
Hospital Serdang Kajang Malaysia.
Circ Rep. 2024 Jul 6;6(8):333-340. doi: 10.1253/circrep.CR-24-0037. eCollection 2024 Aug 9.
One-month dual antiplatelet therapy (DAPT) in high bleeding risk (HBR) patients undergoing percutaneous coronary intervention (PCI) with the Resolute Onyx zotarolimus-eluting stents (ZES) is safe and effective. Asian patients have a unique ischemia/bleeding risk profile. Here, we compare the outcomes between Asian and non-Asian patients after PCI and 1-month DAPT.
Onyx ONE Clear was a prospective, multicenter study enrolling HBR patients undergoing PCI with the Resolute Onyx ZES (ClinicalTrials.gov identifier NCT03647475). Event-free patients after 1-month DAPT transitioned to single antiplatelet therapy. Clinical outcomes between 1 month and 2 years were compared between patients from Asian and non-Asian countries after 1 : 1 propensity score matching accounting for baseline differences. Patients from Asian countries represented 18% (n=273) of the study group (n=1,507). Non-Asian patients had greater clinical complexity; however, these differences were minimal after matching. There were no significant differences in ischemic outcomes between matched cohorts from 1 month to 2 years, including the primary composite endpoint of cardiac death or myocardial infarction (12% vs. 12%; P>0.99). However, there were significantly fewer Bleeding Academic Research Consortium types 3-5 bleeding events in the Asian vs. non-Asian cohort (4% vs. 9%; P=0.007), despite similar bleeding risk profiles after matching.
After propensity score matching, HBR patients from Asian countries undergoing PCI treated with 1-month DAPT had similar ischemic outcomes but fewer bleeding events between 1 month and 2 years compared with patients from non-Asian countries.
对于接受经皮冠状动脉介入治疗（PCI）并植入雷帕霉素洗脱支架（ZES）的高出血风险（HBR）患者，为期1个月的双重抗血小板治疗（DAPT）是安全有效的。亚洲患者具有独特的缺血/出血风险特征。在此，我们比较PCI术后及1个月DAPT治疗后亚洲和非亚洲患者的结局。
Onyx ONE Clear是一项前瞻性、多中心研究，纳入接受Resolute Onyx ZES进行PCI的HBR患者（ClinicalTrials.gov标识符NCT03647475）。1个月DAPT后无事件的患者转为单一抗血小板治疗。在对基线差异进行1:1倾向评分匹配后，比较亚洲和非亚洲国家患者在1个月至2年期间的临床结局。亚洲国家的患者占研究组（n = 1507）的18%（n = 273）。非亚洲患者的临床复杂性更高；然而，匹配后这些差异很小。从1个月到2年，匹配队列之间的缺血结局无显著差异，包括心源性死亡或心肌梗死的主要复合终点（12%对12%；P>0.99）。然而，尽管匹配后出血风险特征相似，但亚洲队列中出血学术研究联盟3 - 5型出血事件明显少于非亚洲队列（4%对9%；P = 0.007）。
在倾向评分匹配后，接受1个月DAPT治疗的亚洲国家HBR PCI患者与非亚洲国家患者相比，在1个月至2年期间缺血结局相似，但出血事件较少。
