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Open Access 01-08-2018 | Original Article

Vascular response to biolimus A-9 eluting stent in patients with shorter and prolonged dual antiplatelet therapy: optical coherence tomography sub-study of the NIPPON trial

Authors: Koji Kuroda, Toshiro Shinke, Hiromasa Otake, Hiroto Kinutani, Raisuke Iijima, Junya Ako, Hisayuki Okada, Yoshiaki Ito, Kenji Ando, Hitoshi Anzai, Hiroyuki Tanaka, Yasunori Ueda, Shin Takiuchi, Yasunori Nishida, Hiroshi Ohira, Katsuhiro Kawaguchi, Makoto Kadotani, Hiroyuki Niinuma, Kazuto Omiya, Takashi Morita, Kan Zen, Yoshinori Yasaka, Kenji Inoue, Sugao Ishiwata, Masahiko Ochiai, Toshimitsu Hamasaki, Kazushi Urasawa, Toru Kataoka, Minoru Yoshiyama, Kenshi Fujii, Takumi Inoue, Masahito Kawata, Hiroyoshi Yokoi, Masato Nakamura, On behalf of the NIPPON investigators

Published in: Heart and Vessels | Issue 8/2018

Abstract

Dual antiplatelet therapy (DAPT) with thienopyridine and aspirin is the standard care for the prevention of stent thrombosis. However, the optimal duration and effect of the duration of DAPT on intra-stent thrombus (IS-Th) formation are unknown. The NIPPON study (Nobori Dual Antiplatelet Therapy as Appropriate Duration) was an open label, randomized multicenter, assessor-blinded, trial designed to demonstrate the non-inferiority of shorter (6-month) DAPT to prolonged (18-month) DAPT, after biolimus A9 eluting stent implantation in 3773 patients at 130 sites in Japan. Among them, 101 patients were randomly allocated for an optical coherence tomography (OCT) sub-study to assess the difference of local IS-Th formation between the two groups. In addition to standard OCT parameters, the number of IS-Th formed was counted in each target stent at 8 months. Baseline patient characteristics were not different between the 6- and 18-month groups. IS-Th was detected in 9.8% of the cases and the presence of IS-Th was not significantly different between the two groups (10.9% in 6-month vs. 9.1% in 12-month, P = 0.76). Furthermore, the number of IS-Th formed was not significantly different between the two groups. This OCT sub-study was in line with the main NIPPON study which demonstrated the non-inferiority of 6-month DAPT to 18-month DAPT. Shorter DAPT duration did not promote progressive IS-Th formation at the mid-term time point.

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Title: Vascular response to biolimus A-9 eluting stent in patients with shorter and prolonged dual antiplatelet therapy: optical coherence tomography sub-study of the NIPPON trial
Authors: Koji Kuroda
Toshiro Shinke
Hiromasa Otake
Hiroto Kinutani
Raisuke Iijima
Junya Ako
Hisayuki Okada
Yoshiaki Ito
Kenji Ando
Hitoshi Anzai
Hiroyuki Tanaka
Yasunori Ueda
Shin Takiuchi
Yasunori Nishida
Hiroshi Ohira
Katsuhiro Kawaguchi
Makoto Kadotani
Hiroyuki Niinuma
Kazuto Omiya
Takashi Morita
Kan Zen
Yoshinori Yasaka
Kenji Inoue
Sugao Ishiwata
Masahiko Ochiai
Toshimitsu Hamasaki
Kazushi Urasawa
Toru Kataoka
Minoru Yoshiyama
Kenshi Fujii
Takumi Inoue
Masahito Kawata
Hiroyoshi Yokoi
Masato Nakamura
On behalf of the NIPPON investigators
Publication date: 01-08-2018
Publisher: Springer Japan
Published in: Heart and Vessels / Issue 8/2018
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-018-1131-7

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