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1-Month or 3-Month DAPT in Women and Men at High Bleeding Risk Undergoing PCI
Open accessAbstract
Background In patients at high bleeding risk (HBR), short dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is associated with reduced bleeding and preserved ischemic protection.Objectives The aim of this study was to compare 2 short DAPT regimens, followed by aspirin monotherapy, in women and men at HBR undergoing PCI.Methods Data from 3 prospective, international studies (XIENCE Short DAPT Program) including patients at HBR undergoing PCI with fluoropolymer-based cobalt-chromium everolimus-eluting stents (XIENCE) were analyzed. The primary endpoint was the composite of death or myocardial infarction (MI) at 1 year. The key secondary endpoint was Bleeding Academic Research Consortium (BARC) types 2 to 5 bleeding.Results Among 3,364 patients, 1,154 (34.3%) were women. At 1 year, the rates of death or MI (7.6% vs 8.1%) and BARC types 2 to 5 bleeding (9.5% vs 9.2%) were similar in women and men. One-month and 3-month DAPT conferred a similar risk for death or MI in women (adjusted HR: 0.86; 95% CI: 0.54-1.36) and men (adjusted HR: 1.04; 95% CI: 0.75-1.44) (P for interaction = 0.783). In both sexes, BARC types 2 to 5 bleeding was numerically lower with 1-month DAPT, although not significant after propensity score stratification (women: 7.1% vs 11.2%; adjusted HR: 0.66; 95% CI: 0.43-1.02; men: 8.5% vs 9.7%; adjusted HR: 0.78; 95% CI: 0.57-1.06) (P for interaction = 0.378).Conclusions Among patients at HBR undergoing PCI with everolimus-eluting stents, 1- and 3-month DAPT was associated with similar risk for ischemic events irrespective of sex. In both women and men, 1-month DAPT resulted in less clinically relevant bleeding, although the bleeding risk difference was not significant after propensity score stratification.
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Fluoropolymers such as PTFE, FEP, and PVDF are widely employed in catheters, tubing, and filter membranes due to low friction, biocompatibility, and sterilization resilience, which are critical for life-supporting devices like neonatal catheters, feeding lines, endotracheal tubes, ECMO circuits, and dialysis systems.
“Fluoropolymers such as PTFE, FEP, and PVDF are widely employed in catheters, tubing, and filter membranes due to their low friction, biocompatibility, and sterilization resilience, which are critical attributes for life-supporting devices like neonatal catheters, feeding lines, endotracheal tubes, ECMO circuits, and dialysis systems [24].”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [24]
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References 33 · Cited by 7
Research works printed but not linked: 1
- Feres, 2013, Three vs twelve months of dual antiplatelet therapy after zotarolimus-eluting stents: the OPTIMIZE randomized trial, JAMA, 310, 2510
Metadata
- Authors
- Kunadian, V., Gitto, M., Vogel, B., Sartori, S., Angiolillo, D. J., Bhatt, D. L., Chehab, B. M., Feng, Y., de la Torre Hernandez, J. M., Krucoff, M. W., Maksoud, A., Mankerious, N., Oliva, A., Picon, H., Richardt, G., Sardella, G., Thiele, H., Toelg, R., Varenne, O., Vranckx, P., Windecker, S., Valgimigli, M., & Mehran, R.
- Affiliations
- Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
- Humanitas University (IT)
- Icahn School of Medicine at Mount Sinai (US)
- University of Florida (US)
- Ascension Via Christi Hospital (US)
- Duke Medical Center (US)
- University of Kansas (US)
- Zagazig University (EG)
- Asklepios (DE)
- Policlinico Umberto I (IT)
- Hôpital Cochin (FR)
- Hasselt University (BE)
- University of Bern (CH)
- University Hospital of Bern (CH)
- Corresponding author
- Kunadian, Vijay
- Gitto, Mauro
- Mehran, Roxana
- ORCID
- Kunadian, Vijay
- Gitto, Mauro
- Vogel, Birgit
- Sartori, Samantha
- Angiolillo, Dominick J.
- Bhatt, Deepak L.
- Chehab, Bassem M.
- Feng, Yihan
- de la Torre Hernandez, Jose M.
- Maksoud, Aziz
- Mankerious, Nader
- Oliva, Angelo
- Sardella, Gennaro
- Thiele, Holger
- Varenne, Olivier
- Vranckx, Pascal
- Windecker, Stephan
- Valgimigli, Marco
- Mehran, Roxana
- Venue
- JACC: Cardiovascular Interventions
- Publisher
- Elsevier BV
- Published
- 2025-04
- Volume
- 18
- Issue
- 7
- Pages
- 866-878
- ISSN
- 1876-7605 (ISSN-L)
- 1936-8798
- OpenAlex
- W4407725039
- Cited by
- 7
- References
- 33
- Citations by year
- 2026: 2 · 2025: 5
- FWCI
- 4.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- JACC: Cardiovascular Interventions (publishedVersion)
- PubMed (publishedVersion)
- Document Server@UHasselt (UHasselt) (submittedVersion, other-oa)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Abbott
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- dual antiplatelet therapy, high bleeding risk, percutaneous coronary intervention, everolimus-eluting stent, sex differences, bleeding events, myocardial infarction, mortality, aspirin monotherapy, women, propensity score stratification, ischemic protection, propensity score matching
- MeSH terms
- Everolimus, Dual Anti-Platelet Therapy, Aged, Aspirin, Chromium Alloys, Coronary Artery Disease, Drug Administration Schedule, Female, Hemorrhage, Humans, Male, Middle Aged, Myocardial Infarction, Platelet Aggregation Inhibitors, Prospective Studies, Prosthesis Design, Risk Factors, Sex Factors, Time Factors, Treatment Outcome, Risk Assessment, Drug-Eluting Stents, Percutaneous Coronary Intervention
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