Authors: Jose M de la Torre Hernandez, Ramon Lopez Palop, Jesus M Jimenez Mazuecos, Pilar Carrillo Sáez, Alejandro Gutierez-Barrios, Eduardo Pinar, Belen Cid, Luis Fernandez, Tamara Garcia Camarero, Cristóbal Urbano-Carrillo, Juan F Oteo Dominguez, Victor A Jimenez Diaz, Antonio E. Gomez Menchero, Eladio Galindo Fernández, Juan G. Córdoba Soriano, Raymundo Ocaranza, Eduardo Arroyo Úcar, Koldobika Garcia San Roman, Silvio Leal, Ginés Martínez Cáceres, Jose A Linares Vicente, Georgina Fuertes Ferre, Xavier Carrillo, Juan C. Rama Merchán, Catia Costa, Juan Sanchis, Renato Fernandes, Alberto Rodrigues, Jose M Vegas Valle, Hélder Pereira, Armando Perez de Prado.
RATIONALE
The SIERRA-75 registry was designed to evaluate clinical outcomes in elderly patients who are prescribed an antithrombotic regimen guided by assessement of ischemic and bleeding risks after PCI with the last generation of EES (Sierra® stent, Abbott, Santa Clara, US).
METHODS
Prospective multicenter registry including patients over 75 years revascularized with EES and antithrombotic therapy guided by clinical presentation, PCI complexity and PRECISE DAPT score.
A) No indication for chronic oral anticoagulation:
1) Stable condition and no complex PCI: PRECISE DAPT score ≥ 25 Short therapy (1-3 months); PRECISE DAPT score < 25 Long therapy (6 months).
2) Acute coronary syndrome or complex PCI: PRECISE DAPT score ≥ 25 Short therapy (3-6 months); PRECISE DAPT score < 25 Long therapy (12 months)
B) Indication for chronic oral anticoagulation:
1) Stable condition and no complex PCI: PRECISE DAPT score ≥ 25 Short therapy (Triple therapy NO or < 1 month / dual therapy 6 months); PRECISE DAPT score < 25 Long therapy (Triple therapy 1 month / dual therapy > 6 months).
2) Acute coronary syndrome or complex PCI: PRECISE DAPT score ≥ 25 Short therapy (Triple therapy ≤ 1 month / dual therapy 6 months); PRECISE DAPT score < 25 Long therapy (Triple therapy 1-3 months / dual therapy 12 months).
Co-primary safety endpoints were: 1) composite of cardiac death, myocardial infarction and stent thrombosis; 2) bleeding (BARC 2-5). Primary efficacy endpoint was target lesion revascularization. A matched group of patients revascularized with current DES and no such tailored antithrombotic therapy was used as control.
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