ヤマグチ　ジユンイチ   YAMAGUCHI Jiyun'ichi   山口　淳一    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Safety and Efficacy of Low-Dose Prasugrel as Part of Triple Therapy With Aspirin and Oral Anticoagulants in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention - From the TWMU-AF PCI Registry.
掲載誌名	正式名：Circulation journal : official journal of the Japanese Circulation Society 略　 称：Circ J ISSNコード：1346-9843/1347-4820
掲載区分	国内
出版社	The Japanese Circulation Society
巻・号・頁	83(5),pp.1000-1005
著者・共著者	OOTSUKI Hisao†, YAMAGUCHI Junichi*, KAWAMOTO Takanori, YOSHIKAWA Masafumi, EBIHARA Suguru, TANAKA Kazuki, NAKAO Masashi, JUJO Kentaro, ARASHI Hiroyuki, OOTA Yoshimi, SAITO Katsumi, TAKAGI Atsushi, TANAKA Hiroyuki, FUJII Shinya, HONDA Atsushi, MORI Fumiaki, HAGIWARA Nobuhisa
担当区分	責任著者
発行年月	2019/04
概要	BACKGROUND: Using the standard maintenance dose of prasugrel (10 mg/day) as part of triple therapy with aspirin and an oral anticoagulant (OAC) is not recommended in the current guidelines because it increases the risk of bleeding compared with clopidogrel. However, the safety and efficacy of low-dose prasugrel (3.75 mg/day) as part of triple therapy has not been reported. Methods and Results: We registered 816 consecutive patients with atrial fibrillation (AF) who underwent percutaneous coronary intervention (PCI) from January 2011 to June 2016 at 8 hospitals in Japan. We examined the clinical outcomes of patients who received either low-dose prasugrel (n=57) or clopidogrel (n=451) as part of triple therapy after PCI. The incidences of bleeding (TIMI major and minor) and major adverse cerebrocardiovascular events (MACCE; all-cause death, nonfatal myocardial infarction, stent thrombosis, unplanned revascularization, and stroke) were evaluated. The cumulative 1-year incidence of bleeding was not significantly different (prasugrel 5.6% vs. clopidogrel 8.1%, log-rank P=0.55). In addition, the cumulative 1-year incidence of MACCE was also not significantly different (prasugrel 11.5% vs. clopidogrel 12.3%, log-rank P=0.88). CONCLUSIONS: Low-dose prasugrel, as part of triple therapy, did not increase the risk of bleeding compared with clopidogrel. Therefore, it can be an alternative to clopidogrel for patients with AF undergoing PCI.
DOI	10.1253/circj.CJ-18-1113
PMID	30918236