AimsWe conducted a prespecified subanalysis of the POEM trial to assess the association between sex and clinical outcomes following a short 1‐month dual‐antiplatelet‐therapy (DAPT) period after percutaneous coronary intervention (PCI) with bioresorbable polymer everolimus‐eluting stent (BP‐EES) among patients at high bleeding risk (HBR).BackgroundShortening the DAPT period after PCI is an effective bleeding avoidance strategy with contemporary drug‐eluting stents. Whether sex affects the risk of adverse events following PCI is still debated.MethodsPatients at HBR undergoing PCI with BP‐EES were enrolled and treated with 1‐month DAPT. If anticoagulation was needed, study participants received an oral anticoagulant (OAC) in addition to a P2Y12 inhibitor for 1 month, followed by OAC only thereafter. The primary endpoint was a composite of cardiac death, myocardial infarction, or definite/probable stent thrombosis at 12 months. We report sex‐based outcomes of patients included in the POEM study.ResultsWe enrolled 129 (29.1%) women and 314 (70.9%) men. Women were older, with lower hemoglobin levels, and worse renal function. Accordingly, they had a trend for a greater number of HBR criteria fulfilled and a higher PARIS bleeding score. However, they were not at a significantly higher risk for the primary endpoint (men vs. women: 5.17% vs. 3.94%; HR 1.30; 95% CI: 0.48‐3.54, p = 0.61), or any of the hemorrhagic and ischemic secondary endpoints.ConclusionsThis prespecified subanalysis of the POEM trial suggests that 1‐month DAPT following PCI with BP‐EES may be a safe and effective therapeutic strategy for women at HBR.

中文翻译：

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高出血风险女性接受生物可降解聚合物依维莫司洗脱支架植入后一个月的 DAPT：来自 POEM 试验的见解


目的我们对 POEM 试验进行了预先指定的亚分析，以评估使用生物可吸收聚合物依维莫司洗脱支架 (BP-) 进行经皮冠状动脉介入治疗 (PCI) 后短暂的 1 个月双抗血小板治疗 (DAPT) 期后性别与临床结果之间的关联。高出血风险 (HBR) 患者中的 EES）。背景缩短 PCI 后的 DAPT 时间是使用当代药物洗脱支架的有效避免出血策略。性别是否影响 PCI 后不良事件的风险仍有争议。 方法 HBR 接受 PCI 联合 BP-EES 的患者入组并接受 1 个月的 DAPT 治疗。如果需要抗凝治疗，研究参与者除 P2Y12 抑制剂外还接受口服抗凝剂 (OAC) 治疗 1 个月，此后仅接受 OAC。主要终点是 12 个月时心源性死亡、心肌梗塞或明确/可能的支架血栓形成的复合终点。我们报告了 POEM 研究中患者的基于性别的结果。结果我们招募了 129 名女性 (29.1%) 和 314 名男性 (70.9%)。女性年龄较大，血红蛋白水平较低，肾功能较差。因此，他们有越来越多的 HBR 标准得到满足以及较高的 PARIS 出血评分的趋势。然而，他们的主要终点风险并不显着更高（男性与女性：5.17% vs. 3.94%；HR 1.30；95% CI：0.48-3.54，p = 0.61），或任何出血性和缺血性事件结论 POEM 试验的这项预先指定的子分析表明，对于 HBR 女性来说，PCI 后 1 个月的 DAPT 联合 BP-EES 可能是一种安全有效的治疗策略。