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EXCELLENT
EXCELLENTHC Gwon (Sungkyunkwan University School of Medicine, Seoul, Korea)American College of Cardiology 2011 Scientific ...
EXCELLENT: Results• No statistically significant difference seen between patients on dual antiplatelet  therapy for six mo...
EXCELLENT: Commentary*"The take-home message from our study is that, at least in low-risk, nondiabeticpatients treated wit...
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EXCELLENT trial - Summary & Results

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http://www.theheart.org/web_slides/1233119.do

A randomized study on EXCELLENT with patients treated with the everolimus-eluting stent (Xience V/Promus) or the sirolimus-eluting stent (Cypher Select)

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EXCELLENT trial - Summary & Results

  1. 1. EXCELLENT
  2. 2. EXCELLENTHC Gwon (Sungkyunkwan University School of Medicine, Seoul, Korea)American College of Cardiology 2011 Scientific Sessions• A 2X2 factorial study• Population and treatment: 1443 patients with coronary artery disease Randomized to dual antiplatelet therapy for six months or dual antiplatelet therapy for one year In the first randomization, patients were treated with the everolimus-eluting stent (Xience V/Promus) or the sirolimus-eluting stent (Cypher Select)• Primary outcome: For the antiplatelet randomization: target vessel failure (TVF), a composite of cardiac death, MI, or target vessel revascularization at 12 months For the stent randomization: effect on late lumen loss (results reported in 2010)
  3. 3. EXCELLENT: Results• No statistically significant difference seen between patients on dual antiplatelet therapy for six months and those treated for one year: Rate of TVF 4.7% and 4.4% for six months and one year, respectively; met statistical criteria for noninferiority• No difference seen between the two groups in terms of other end points: Cardiac death, MI, stent thrombosis, or TIMI major bleeding, as well as the combined safety end point*• Subgroup analyses of the primary end point: No difference when patients stratified by age, LVEF, or complexity of disease Significantly increased risk of TVF (>3X) among diabetes patients treated for just six months*Death, MI, stent thrombosis, stroke, or TIMI major bleedingLVEF: left ventricular ejection fraction
  4. 4. EXCELLENT: Commentary*"The take-home message from our study is that, at least in low-risk, nondiabeticpatients treated with second-generation drug-eluting stents, we can safelydiscontinue clopidogrel at about six months." - Dr Hyeon-Cheol Gwon"Just 60% of our patients are stopping dual antiplatelet therapy at six months . . .but its an issue of their primary physicians recommending that they continue ontreatment. Its a notion of, Well, youre doing fine on it, you can afford it, and yourenot having bleeding problems. . . . In some ways, its a case of treating ourselvesinstead of the patient based on the evidence." - Dr David Kandzari*All comments from EXCELLENT results for stopping DAPT at six months, but others say bigger trialsare needed (http://www.theheart.org/article/1208053.do)
  5. 5. Become a member of http://www.theheart.org Become a fan on Facebook: http://www.facebook.com/theheartorg Follow us on Twitter: http://www.twitter.com/theheartorgtheheart.org is the leading online source of independent cardiology news.We are the top provider of news and opinions for over 100 000 physicians.

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