Yamada Takehiro, Tokuda Takahiro, Yoshioka Naoki, Koyama Akio, Nishikawa Ryusuke, Shimamura Kiyotaka, Aoyama Takuma
Division of Cardiology, Central Japan International Medical Center, Minokamo, Gifu, Japan.
Division of Cardiology, Nagoya Heart Center, Nagoya, Aichi, Japan.
Ann Vasc Dis. 2024 Dec 25;17(4):396-404. doi: 10.3400/avd.oa.24-00056. Epub 2024 Nov 29.
Evidence for antithrombotic therapy after endovascular therapy (EVT) is limited. This retrospective, multicenter, observational study enrolled 732 consecutive patients with lower extremity artery disease who underwent EVT between January 2018 and December 2019. Overall, 570 patients who received single antiplatelet therapy (SAPT) and dual antiplatelet therapy (DAPT) were selected and divided into the SAPT (n = 189) and DAPT (n = 381) groups. The primary outcome was bleeding events at 24 months. The secondary outcomes were bleeding events at 30 days and 24 months after 30 days, ischemic events, and all-cause death at 24 months. Bleeding and ischemic events at 24 months were investigated in subgroups. A propensity score matching yielded 164 patients in both groups. There were no significant differences in bleeding events between the SAPT and DAPT groups (14.2% and 11.3% at 24 months, p = 0.775; 2.5% and 6.1% at 30 days, p = 0.106; 11.7% and 6.7% at 24 months after 30 days, p = 0.162). Additionally, there was no significant difference in ischemic events at 24 months between the two groups (32.7% and 30.6%, p = 0.625). Bleeding and ischemic events at 24 months were similar between subgroups. No significant differences in bleeding or ischemic events between SAPT and DAPT were observed.
血管内治疗（EVT）后抗血栓治疗的证据有限。这项回顾性、多中心、观察性研究纳入了2018年1月至2019年12月期间连续732例接受EVT的下肢动脉疾病患者。总体而言，选择了570例接受单一抗血小板治疗（SAPT）和双重抗血小板治疗（DAPT）的患者，并将其分为SAPT组（n = 189）和DAPT组（n = 381）。主要结局是24个月时的出血事件。次要结局是30天时的出血事件、30天后24个月时的出血事件、缺血事件以及24个月时的全因死亡。对24个月时的出血和缺血事件进行了亚组研究。倾向评分匹配后两组各有164例患者。SAPT组和DAPT组在出血事件方面无显著差异（24个月时分别为14.2%和11.3%，p = 0.775；30天时分别为2.5%和6.1%，p = 0.106；30天后24个月时分别为11.7%和6.7%，p = 0.162）。此外，两组在24个月时的缺血事件方面也无显著差异（分别为32.7%和30.6%，p = 0.625）。亚组之间24个月时的出血和缺血事件相似。未观察到SAPT和DAPT在出血或缺血事件方面的显著差异。
