GUIDELINE CONCORDANT ANTIPLATELET REGIMENS IN PATIENTS WHO UNDERWENT CAROTID ARTERY REVASCULARIZATION: INSIGHTS FROM THE VASCULAR QUALITY INITIATIVE REGISTRY

Zain Ahmed; Megan Lee; Jiaming Huang; Aaron Brice; Ahmad Arham; Yulanka Castro Dominguez; Edouard Aboian; Sameer Nagpal; Kim Smolderen; Carlos Mena Hurtado

doi:10.1016/S0735-1097(21)02437-2

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GUIDELINE CONCORDANT ANTIPLATELET REGIMENS IN PATIENTS WHO UNDERWENT CAROTID ARTERY REVASCULARIZATION: INSIGHTS FROM THE VASCULAR QUALITY INITIATIVE REGISTRY

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GUIDELINE CONCORDANT ANTIPLATELET REGIMENS IN PATIENTS WHO UNDERWENT CAROTID ARTERY REVASCULARIZATION: INSIGHTS FROM THE VASCULAR QUALITY INITIATIVE REGISTRY

Zain Ahmed, Megan Lee, Jiaming Huang, Aaron Brice, Ahmad Arham, Yulanka Castro Dominguez, Edouard Aboian, Sameer Nagpal, Kim Smolderen and Carlos Mena Hurtado

Journal of the American College of Cardiology, Vol.77(18 Supplement 1), pp.1078-1078

05/11/2021

DOI: 10.1016/S0735-1097(21)02437-2

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Abstract

Background Antiplatelet regimens for patients undergoing revascularization for carotid artery stenosis are guided by Class I recommendations, with dual antiplatelet therapy (DAPT) indicated following carotid artery stenting (CAS) and single antiplatelet therapy (SAPT) following carotid endarterectomy (CEA). It remains unknown how these guidelines are being adhered to in real world practice. Methods We examined patients who underwent CEA or CAS between January 1, 2014-December 31, 2019 from the Vascular Study Group of New England (VSGNE) registry. Median odds ratios (MORs) were adjusted for potential confounders to assess site variability. Results Of 12,257 patients, the mean age was 70.6 ± 9.1 years for CEA (n= 9,661) and 70.1 ± 9.9 years for CAS (n = 2,596). For the CEA cohort, 66.3% were discharged on SAPT and 5.9% were discharged on no antiplatelet agent. Other antiplatelet variations included 19.7% on DAPT and 1.8% on triple therapy (DAPT plus anticoagulation) following CEA. Among the CAS cohort, 81.7% were discharged on at least DAPT, 4.2% on SAPT, and 6.7% on no antiplatelet agent. The site variability as measured by adjusted MOR was 1.56 (95% CI: 1.09, 1.87) for being on SAPT following CEA and 1.62 (not significant) for being on at least DAPT following CAS (see Figure 1). Conclusion In a large, contemporary real-world registry, a high percentage of patients undergoing CAS appropriately received DAPT. However, there was greater variability in the use of SAPT following CEA with lower adherence rates.

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Title: Subtitle: GUIDELINE CONCORDANT ANTIPLATELET REGIMENS IN PATIENTS WHO UNDERWENT CAROTID ARTERY REVASCULARIZATION: INSIGHTS FROM THE VASCULAR QUALITY INITIATIVE REGISTRY
Creators: Zain Ahmed - Yale University
Megan Lee - Yale University
Jiaming Huang - Yale University
Aaron Brice - Yale University
Ahmad Arham - Yale University
Yulanka Castro Dominguez - Yale University
Edouard Aboian - Yale University
Sameer Nagpal - Yale University
Kim Smolderen - Yale University
Carlos Mena Hurtado - Yale University
Resource Type: Abstract
Publication Details: Journal of the American College of Cardiology, Vol.77(18 Supplement 1), pp.1078-1078
DOI: 10.1016/S0735-1097(21)02437-2
ISSN: 0735-1097
Publisher: Elsevier
Language: English
Date published: 05/11/2021
Academic Unit: Internal Medicine
Record Identifier: 9985157627702771

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