Analysis of 45 cases of early interruption of dual antiplatelet therapy after percutaneous coronary intervention
10.3969/j.issn.1004-8812.2024.08.004
- VernacularTitle:经皮冠状动脉介入治疗后早期中断双联抗血小板治疗45例分析
- Author:
Wei-Zhe XIAO
1
;
Chuan-Qiang WANG
;
Yang YANG
;
Ke CHEN
;
Jing LIU
;
Wen-Liang XIAO
Author Information
1. 河北医科大学第三医院急诊科,河北石家庄 050051
- Keywords:
Percutaneous coronary intervention;
Dual antiplatelet therapy;
Major adverse cardiovascular events
- From:
Chinese Journal of Interventional Cardiology
2024;32(8):443-446
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the incidence of major adverse cardiovascular events(MACE)in 45 patients who unexpectedly interrupted dual antiplatelet therapy(DAPT)within one month after percutaneous coronary intervention(PCI).Methods A total of 4 876 patients who successfully underwent PCI and implanted one or more stents(excluding acute ST segment elevation myocardial infarction,drug coated balloon or non-drug coated ballooon only,and oral anticoagulants)between January 1,2017 and December 31,2022 were selected as the study subjects.A total of 45 patients with unexpected interruption of DAPT within one month after PCI were analyzed,and their clinical outcomes were followed up.Results Among the 45 patients,there were 29 males and 16 females,aged 48-80(61.7+15.3)years.The reasons for interrupting DAPT include:35 cases of bleeding;3 cases of malignant tumor surgery(including 2 bleeding patients);5 cases of trauma;2 cases of hematological diseases;2 cases of self-interruption of DAPT.6 patients who received low-molecular-weight heparin replacement therapy during the discontinuation period did not experience stent thrombosis or other MACE.Among the 39 patients without antithrombotic replacement therapy,5 developed stent thrombosis and acute myocardial infarction(5/45,11.1％).Except for 1 patient who voluntarily stopped DAPT 2 weeks after PCI,the remaining 4 cases were those who with concurrent bleeding within 2 weeks after PCI.DAPT was stopped for more than 10 days,and stent thrombosis occurred on the 10th,11th,11th,and 13th days after DAPT was stopped.Among the 4 patients,2 patients developed acute left heart failure and 1 patient died.Another case died due to brainstem hemorrhage.Conclusions Premature interruption of DAPT after PCI has a high potential risk.Patients who stop taking medication earlier,for a longer duration,and without replacement therapy have a higher risk.
