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Incidence and impact of antiplatelet therapy cessation among very older patients with stable coronary artery disease
Objectives: Long-term use of evidence-based antiplatelet therapy is recommended for management of stable coronary artery disease (SCAD). However, non-adherence to antiplatelet drugs is common in older patients. This study aimed to evaluate the incidence and impact of antiplatelet therapy cessation o...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277504/ https://www.ncbi.nlm.nih.gov/pubmed/37342591 http://dx.doi.org/10.3389/fphar.2023.1183839 |
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author | Zou, Xiao Wang, Liang Sun, Sha-Sha Hu, Yi-Xin Liu, Hong-Wei Wang, Hao Cao, Jian Liu, Hong-Bin Fan, Li |
author_facet | Zou, Xiao Wang, Liang Sun, Sha-Sha Hu, Yi-Xin Liu, Hong-Wei Wang, Hao Cao, Jian Liu, Hong-Bin Fan, Li |
author_sort | Zou, Xiao |
collection | PubMed |
description | Objectives: Long-term use of evidence-based antiplatelet therapy is recommended for management of stable coronary artery disease (SCAD). However, non-adherence to antiplatelet drugs is common in older patients. This study aimed to evaluate the incidence and impact of antiplatelet therapy cessation on clinical outcomes of older patients with SCAD. Methods: A total of 351 consecutive eligible very older patients (≥80 years) with SCAD from the PLA General Hospital were included. Baseline demographics, clinical characteristics, and clinical outcomes were collected during follow-up. Patients were divided into cessation group and standard group based on whether discontinuing of antiplatelet drugs. The primary outcome was major adverse cardiovascular events (MACE) and secondary outcomes were minor bleeding and all-cause mortality. Results: A total of 351 participants, with a mean age of 91.76 ± 5.01 years old (range 80–106 years) were included in statistical analysis. The antiplatelet drug cessation rate was 60.1%. There were 211 patients in cessation group and 140 patients in standard group. During a median follow-up of 98.6 months, the primary outcome of MACE occurred in 155 patients (73.5%) in the cessation group and 84 patients (60.0%) in the standard group (HR = 1.476, 95% CI:1.124-1.938, p = 0.005). Cessation of antiplatelet drugs increased the rates of angina (HR = 1.724, 95% CI:1.211-2.453, p = 0.002) and non-fatal MI (HR = 1.569, 95% CI:1.093-2.251, p = 0.014). The secondary outcomes of minor bleeding and all-cause mortality were similar between the two groups. Conclusion: Among very older patients with SCAD, antiplatelet therapy cessation significantly increased the risk of MACE, and continuous antiplatelet drug therapy didn’t increase the risk of minor bleeding. |
format | Online Article Text |
id | pubmed-10277504 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-102775042023-06-20 Incidence and impact of antiplatelet therapy cessation among very older patients with stable coronary artery disease Zou, Xiao Wang, Liang Sun, Sha-Sha Hu, Yi-Xin Liu, Hong-Wei Wang, Hao Cao, Jian Liu, Hong-Bin Fan, Li Front Pharmacol Pharmacology Objectives: Long-term use of evidence-based antiplatelet therapy is recommended for management of stable coronary artery disease (SCAD). However, non-adherence to antiplatelet drugs is common in older patients. This study aimed to evaluate the incidence and impact of antiplatelet therapy cessation on clinical outcomes of older patients with SCAD. Methods: A total of 351 consecutive eligible very older patients (≥80 years) with SCAD from the PLA General Hospital were included. Baseline demographics, clinical characteristics, and clinical outcomes were collected during follow-up. Patients were divided into cessation group and standard group based on whether discontinuing of antiplatelet drugs. The primary outcome was major adverse cardiovascular events (MACE) and secondary outcomes were minor bleeding and all-cause mortality. Results: A total of 351 participants, with a mean age of 91.76 ± 5.01 years old (range 80–106 years) were included in statistical analysis. The antiplatelet drug cessation rate was 60.1%. There were 211 patients in cessation group and 140 patients in standard group. During a median follow-up of 98.6 months, the primary outcome of MACE occurred in 155 patients (73.5%) in the cessation group and 84 patients (60.0%) in the standard group (HR = 1.476, 95% CI:1.124-1.938, p = 0.005). Cessation of antiplatelet drugs increased the rates of angina (HR = 1.724, 95% CI:1.211-2.453, p = 0.002) and non-fatal MI (HR = 1.569, 95% CI:1.093-2.251, p = 0.014). The secondary outcomes of minor bleeding and all-cause mortality were similar between the two groups. Conclusion: Among very older patients with SCAD, antiplatelet therapy cessation significantly increased the risk of MACE, and continuous antiplatelet drug therapy didn’t increase the risk of minor bleeding. Frontiers Media S.A. 2023-06-05 /pmc/articles/PMC10277504/ /pubmed/37342591 http://dx.doi.org/10.3389/fphar.2023.1183839 Text en Copyright © 2023 Zou, Wang, Sun, Hu, Liu, Wang, Cao, Liu and Fan. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pharmacology Zou, Xiao Wang, Liang Sun, Sha-Sha Hu, Yi-Xin Liu, Hong-Wei Wang, Hao Cao, Jian Liu, Hong-Bin Fan, Li Incidence and impact of antiplatelet therapy cessation among very older patients with stable coronary artery disease |
title | Incidence and impact of antiplatelet therapy cessation among very older patients with stable coronary artery disease |
title_full | Incidence and impact of antiplatelet therapy cessation among very older patients with stable coronary artery disease |
title_fullStr | Incidence and impact of antiplatelet therapy cessation among very older patients with stable coronary artery disease |
title_full_unstemmed | Incidence and impact of antiplatelet therapy cessation among very older patients with stable coronary artery disease |
title_short | Incidence and impact of antiplatelet therapy cessation among very older patients with stable coronary artery disease |
title_sort | incidence and impact of antiplatelet therapy cessation among very older patients with stable coronary artery disease |
topic | Pharmacology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277504/ https://www.ncbi.nlm.nih.gov/pubmed/37342591 http://dx.doi.org/10.3389/fphar.2023.1183839 |
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