Diabetes and outcomes following personalized antiplatelet therapy in coronary artery disease patients who underwent PCI.
Diabetes and outcomes following personalized antiplatelet therapy in coronary artery disease patients who underwent PCI.
复制标题
接受 PCI 的冠状动脉疾病患者进行个性化抗血小板治疗后的糖尿病和结果。
DOI：
10.1210/clinem/dgab612
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发表时间：
2021-08
期刊：
影响因子：
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通讯作者：
Xie Xiang
中科院分区：
文献类型：
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作者：
Zheng Ying-Ying;Wu Ting-Ting;Yang Yi;Hou Xian-Geng;Chen You;Ma Xiang;Ma Yi-Tong;Zhang Jing-Ying;Xie Xiang
背景：在接受经皮冠状动脉介入治疗（PCI）的稳定型冠状动脉疾病（CAD）患者中，由一种新型血小板功能检测（PFT）即PL - 12指导的个性化抗血小板治疗被视为一种优化的治疗策略。然而，任何……的安全性和有效性
BACKGROUND
A personalized antiplatelet therapy guided by a novel platelet function testing (PFT), PL-12, is considered an optimized treatment strategy in stable coronary artery disease (CAD) patients undergoing PCI. However, the safety and efficacy of any dual antiplatelet therapy (DAPT) strategy may differ in relation to diabetes status. The aim of this study was to compare the outcomes of PFT-guided personalized DAPT in stable CAD patients with and without diabetes mellitus.
METHODS AND RESULTS
The PATH-PCI trial randomized 2285 stable CAD patients to either personalized antiplatelet therapy or standard antiplatelet treatment. We investigated the association and interaction of diabetes on clinical outcomes across two treatment groups. We did not find significant difference between the personalized group and the standard group in net adverse clinical events either in diabetes patients (10.3% vs. 13.4%, P=0.224) or in non-diabetic group (3.1% vs. 5.0%, P=0.064). In diabetes patients (n=646, 28.3%), the overall ischemic event rates were significantly low (6.8% vs. 11.3%, HR=0.586, 95%CI: 0.344-0.999, P=0.049) and the bleeding event rates did not differ between the two groups (3.5% vs. 3.3%, HR=1.066, 95%CI: 0.462-2.458, P=0.882). Similarly, in non-diabetic patients, the overall ischemic event rates were significantly low (1.8% vs. 4.2%, HR=0.428, 95%CI: 0.233-0.758, P=0.006) and the bleeding event rates did not differ between the two groups (1.6% vs. 0.9%, HR=1.802, 95%CI: 0.719-4.516, P=0.209).
CONCLUSIONS
The present study suggests that personalized antiplatelet therapy according to PFT can reduce ischemic events but not increase bleedings in stable CAD patients with or without diabetes who underwent PCI.