{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T10:53:06Z","timestamp":1758279186272},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,11,10]],"date-time":"2016-11-10T00:00:00Z","timestamp":1478736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Clinical Science Research and Development Service of the VA Office of Research and Development","award":["I01CX000440","I01CX001549"],"award-info":[{"award-number":["I01CX000440","I01CX001549"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the impact of stent type on the risk of death or myocardial infarction (MI) related to dual antiplatelet therapy (DAPT) more than 12 months (prolonged DAPT) versus 12 or less months after PCI for an acute coronary syndrome (ACS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The recent DAPT study reported lower recurrent ischemic events from prolonged DAPT in patients treated with PCI for an ACS, but was underpowered to determine the impact of stent type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We determined clinical outcomes after PCI for an ACS (median follow\u2010up: DES\u2009=\u200926 months, BMS\u2009=\u200946 months) in 18,484 patients in the Veterans Affairs system treated with first generation drug\u2010eluting stents (DES) or bare\u2010metal stents (BMS). We used landmark analyses starting 1 year after the index PCI to assess the risk of prolonged DAPT on the primary endpoint of death or MI. Multivariable and propensity models adjusted for confounding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a significant interaction between stent type and prolonged DAPT for death and MI (<jats:italic>P<\/jats:italic>\u2009=\u20090.0036), death (<jats:italic>P<\/jats:italic>\u2009=\u20090.054), and major bleeding (<jats:italic>P<\/jats:italic>\u2009=\u20090.0013). Patients treated with prolonged DAPT had lower risks of death or MI (HR\u2009=\u20090.71, 95% CI\u2009=\u20090.61, 0.82) and death (HR\u2009=\u20090.74, 95%CI\u2009=\u20090.62, 0.89) with DES, but not BMS, and higher risks of major bleeding, particularly with BMS (HR\u2009=\u20091.67, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) than DES (HR\u2009=\u20091.24, p\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prolonging DAPT more than 12 months after PCI for ACS only associated with a lower risk of ischemic events in the 1\u20134 years after PCI in those receiving first generation DES. Stent type may influence the benefit of prolonged DAPT. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26831","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T13:05:31Z","timestamp":1479301531000},"page":"1176-1184","source":"Crossref","is-referenced-by-count":4,"title":["Long\u2010term outcomes in patients with acute coronary syndromes related to prolonging dual antiplatelet therapy more than 12 months after coronary stenting"],"prefix":"10.1002","volume":"89","author":[{"given":"Neil J.","family":"Wimmer","sequence":"first","affiliation":[{"name":"Cardiovascular Division VA Boston Healthcare System Boston Massachusetts"},{"name":"Division of Cardiovascular Medicine Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa B.","family":"Dufour","sequence":"additional","affiliation":[{"name":"MAVERIC, VA Boston Healthcare System Boston 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