Abstract

Background: Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis: We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods: We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results: Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions: Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI.

Original languageEnglish
Pages (from-to)1113-1120
Number of pages8
JournalClinical Cardiology
Volume42
Issue number11
DOIs
Publication statusPublished - Nov 1 2019

Keywords

  • clopidogrel
  • dual antiplatelet therapy
  • percutaneous coronary intervention
  • post-MI
  • secondary prevention
  • ticagrelor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study. / on behalf of the EYESHOT Post-MI Investigators.

In: Clinical Cardiology, Vol. 42, No. 11, 01.11.2019, p. 1113-1120.

Research output: Contribution to journalArticle

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title = "How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study",
abstract = "Background: Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis: We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods: We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results: Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1{\%}) were on DAPT at the time of enrolment, and 450 (27.6{\%}) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions: Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI.",
keywords = "clopidogrel, dual antiplatelet therapy, percutaneous coronary intervention, post-MI, secondary prevention, ticagrelor",
author = "{on behalf of the EYESHOT Post-MI Investigators} and A. Fusco and {Oltrona Visconti}, L. and B. Marinoni and U. Canosi and C. Mauro and {Di Vincenzo}, E. and A. Cherubini and G. Russo and F. Piemonte and {Di Donato}, A. and E. Corrada and D. Cattani and B. Barco and M. Cannone and M. Caputo and M. Montano and G. Tortorella and S. Scalvini and E. Zanelli and G. Riboni and R. Testa and I. Loddo and R. Tramarin and M. Marini and Assanelli, {E. M.} and A. Cabiati and A. Aiello and R. Iorio and R. Antonicelli and S. Conti and M. Persico and E. Barbieri and A. Ruggeri and C. Vigna and G. Farinola and D. Santoro and F. Calabr{\`o} and Finocchiaro, {M. L.} and M. Pieri and P. Costa and S. Russo and A. Maestroni and S. Perotti and D. Cianflone and C. Ricci and E. Bruno and L. Fattore and P. Capogrosso and M. Perotti and {Di Marco}, S. and A. Vicentini and A. Porfidia and L. Testa and A. Antonelli and G. Furgi",
year = "2019",
month = "11",
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doi = "10.1002/clc.23262",
language = "English",
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pages = "1113--1120",
journal = "Clinical Cardiology",
issn = "0160-9289",
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T1 - How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study

AU - on behalf of the EYESHOT Post-MI Investigators

AU - Fusco, A.

AU - Oltrona Visconti, L.

AU - Marinoni, B.

AU - Canosi, U.

AU - Mauro, C.

AU - Di Vincenzo, E.

AU - Cherubini, A.

AU - Russo, G.

AU - Piemonte, F.

AU - Di Donato, A.

AU - Corrada, E.

AU - Cattani, D.

AU - Barco, B.

AU - Cannone, M.

AU - Caputo, M.

AU - Montano, M.

AU - Tortorella, G.

AU - Scalvini, S.

AU - Zanelli, E.

AU - Riboni, G.

AU - Testa, R.

AU - Loddo, I.

AU - Tramarin, R.

AU - Marini, M.

AU - Assanelli, E. M.

AU - Cabiati, A.

AU - Aiello, A.

AU - Iorio, R.

AU - Antonicelli, R.

AU - Conti, S.

AU - Persico, M.

AU - Barbieri, E.

AU - Ruggeri, A.

AU - Vigna, C.

AU - Farinola, G.

AU - Santoro, D.

AU - Calabrò, F.

AU - Finocchiaro, M. L.

AU - Pieri, M.

AU - Costa, P.

AU - Russo, S.

AU - Maestroni, A.

AU - Perotti, S.

AU - Cianflone, D.

AU - Ricci, C.

AU - Bruno, E.

AU - Fattore, L.

AU - Capogrosso, P.

AU - Perotti, M.

AU - Di Marco, S.

AU - Vicentini, A.

AU - Porfidia, A.

AU - Testa, L.

AU - Antonelli, A.

AU - Furgi, G.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Background: Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis: We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods: We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results: Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions: Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI.

AB - Background: Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis: We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods: We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results: Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions: Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI.

KW - clopidogrel

KW - dual antiplatelet therapy

KW - percutaneous coronary intervention

KW - post-MI

KW - secondary prevention

KW - ticagrelor

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U2 - 10.1002/clc.23262

DO - 10.1002/clc.23262

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VL - 42

SP - 1113

EP - 1120

JO - Clinical Cardiology

JF - Clinical Cardiology

SN - 0160-9289

IS - 11

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