Efficacy of dual antiplatelet therapy for preventing recurrence of arterial thrombosis in patients with antiphospholipid syndrome

Ohnishi, Naoki; Fujieda, Yuichiro; Hisada, Ryo; Nakamura, Hiroyuki; Kato, Masaru; Oku, Kenji; Bohgaki, Toshiyuki; Amengual, Olga; Yasuda, Shinsuke; Atsumi, Tatsuya

Efficacy of dual antiplatelet therapy for preventing recurrence of arterial thrombosis in patients with antiphospholipid syndrome

Ohnishi, Naoki; Fujieda, Yuichiro; Hisada, Ryo et al.

Rheumatology, 2019, 58(6), 969-974

Permalink : https://hdl.handle.net/2115/78264

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論文情報

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アクセス権	open access
URI	https://hdl.handle.net/2115/78264
タイトル	Efficacy of dual antiplatelet therapy for preventing recurrence of arterial thrombosis in patients with antiphospholipid syndrome
著者	Ohnishi, Naoki ; Fujieda, Yuichiro ; Hisada, Ryo ; Nakamura, Hiroyuki ; Kato, Masaru ; Oku, Kenji ; Bohgaki, Toshiyuki ; Amengual, Olga ; Yasuda, Shinsuke ; Atsumi, Tatsuya
著者名 Ohnishi, Naoki
e-Rad_Researcher 70790872 著者名 Fujieda, Yuichiro
著者名 Hisada, Ryo
著者名 Nakamura, Hiroyuki
e-Rad_Researcher 10755896 著者名 Kato, Masaru
e-Rad_Researcher 70544295 著者名 Oku, Kenji
e-Rad_Researcher 50431367 著者名 Bohgaki, Toshiyuki
e-Rad_Researcher 10636939 著者名 Amengual, Olga
e-Rad_Researcher 00374231 著者名 Yasuda, Shinsuke
e-Rad_Researcher 20301905 著者名 Atsumi, Tatsuya
言語	英語
キーワード	antiphospholipid syndrome (APS)
	dual antiplatelet therapy (DAPT)
	arterial thrombosis
	venous thrombosis
	prophylaxis
	safety
発行日	2019-06
出版者	Oxford University Press
収録物名	Rheumatology
巻(号)	58(6)
ページ	969-974
抄録	Objective. Warfarin is regarded as the standard treatment for preventing thrombotic events in APS, but the recurrence rate is still high. Dual antiplatelet therapy (DAPT) has been shown to be effective for the prevention of acute coronary syndrome or stroke. The objective of this study was to evaluate the efficacy of DAPT for the prevention of thrombosis recurrence in APS patients with history of arterial thrombosis. Methods. This retrospective cohort study of APS patients was conducted at Hokkaido University Hospital between 1990 and 2016. The secondary prophylactic effects and safety of warfarin monotherapy (Wf), antiplatelet monotherapy (AP), warfarin and antiplatelet combination therapy (Wf + AP) and DAPT were evaluated. The primary endpoints were set as thrombosis-free and adverse events-free survival period. Adverse events were defined as severe bleeding and death. Results. A total of 90 APS patients were enrolled. Thrombotic recurrence was found in 40 patients (35 arterial and 5 venous thromboses) and serious adverse events in 20 patients (9 severe bleeding events and 14 deaths). Kaplan-Meier analysis demonstrated a 10-year recurrence-free survival rate of 62%. The recurrence rate per 100 patient-years was as follows: Wf: 11.6, AP: 5.5, Wf: + AP: 3.7, DAPT: 1.8. We demonstrated that DAPT significantly reduced the rate of recurrence compared with Wf (log-rank P = 0.001). There were no significant differences in the rate of serious adverse events among the groups. Conclusion. DAPT might be considered as an effective and safe option for the prophylaxis of recurrent arterial thrombosis in APS.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Volume 58, Issue 6, June 2019, Pages 969-974, is available online at: https://doi.org/10.1093/rheumatology/key340.
PISSN	1462-0324
関連情報	PMID 30508199
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1093/rheumatology/key340