Benefit of switching dual antiplatelet therapy after acute coronary syndrome: the TOPIC (timing of platelet inhibition after acute coronary syndrome) randomized study
Why the study?
Does a switched DAPT strategy prevent bleeding complications without increasing ischaemic events in patients following acute coronary syndrome?
Population
Patients following acute coronary syndrome (ACS)
Comparison
Switched dual antiplatelet therapy (DAPT) strategy vs Unchanged dual antiplatelet therapy strategy
Design
RCT, Randomized
Authors
Discussion
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Member takes
Implication
May support switching DAPT post-ACS to reduce bleeding; extends low-certainty evidence with RCT data.
Key Points
- To evaluate the safety and efficacy of switching dual antiplatelet therapy compared to maintaining an unchanged regimen in patients following acute coronary syndrome.
- Randomized trial comparing a switched dual antiplatelet therapy (DAPT) strategy against an unchanged DAPT strategy in patients presenting with acute coronary syndrome (ACS).
- A switched DAPT strategy was superior to an unchanged DAPT strategy for reducing bleeding complications.
- The switched antiplatelet regimen achieved lower bleeding rates without causing an increase in ischemic events following ACS.
Structured PICO
Does a switched DAPT strategy prevent bleeding complications without increasing ischaemic events in patients following acute coronary syndrome?
P
Population
Patients following acute coronary syndrome (ACS)
I
Intervention
Switched dual antiplatelet therapy (DAPT) strategy
C
Comparator
Unchanged dual antiplatelet therapy (DAPT) strategy
O
Outcome
Bleeding complications and ischaemic eventssafety
Switching DAPT after ACS reduces bleeding complications without increasing the risk of ischemic events compared to an unchanged DAPT strategy.
Cite This Study
Cuisset et al. (2017) studied this question.