Key result
Short TAT after PCI shows no difference in major events or bleeding versus extended duration.
Why the study?
Balancing ischemic and bleeding risks after PCI in patients requiring anticoagulation remains challenging, and the optimal duration of TAT in the immediate post-procedural phase is uncertain.
Does short-duration triple antithrombotic therapy (< 7 days) improve clinical outcomes compared to extended-duration (≥ 7 days) in patients requiring oral anticoagulation after PCI?
Observational (n=172)
No
Does short-duration triple antithrombotic therapy (< 7 days) improve clinical outcomes compared to extended-duration (≥ 7 days) in patients requiring oral anticoagulation after PCI?
Early de-escalation of triple antithrombotic therapy to under 7 days post-PCI in patients requiring oral anticoagulation appears safe and effective, with similar ischemic and bleeding outcomes compared to extended duration.
Short-duration TAT showed similar outcomes in this cohort; leaves open whether RCTs will confirm safety post-PCI.
BACKGROUND: Balancing ischemic and bleeding risks in patients undergoing percutaneous coronary intervention (PCI) who require anticoagulation remains a clinical challenge. While dual antithrombotic therapy (DAT) with a P2Y12 inhibitor and an oral anticoagulant reduces long-term bleeding risk, the optimal duration of triple antithrombotic therapy (TAT) in the immediate post-procedural phase is uncertain. AIMS: We aimed to evaluate clinical outcomes of short-duration ({7 days) of TAT to extended-duration (≥ 7 days) of triple therapy following PCI. METHODS: We conducted a retrospective observational study of 172 patients who underwent PCI. Of these, 109 received TAT for < 7 days, and 63 received TAT for ≥ 7 but < 28 days. The primary outcome was a composite endpoint of cardiovascular mortality, myocardial infarction, target lesion revascularization, and definite or probable stent thrombosis at 1 year. Secondary outcomes were gastrointestinal bleeding (BARC > 3) and intracranial hemorrhage. RESULTS: There were no statistically significant differences between the two groups in composite outcome (cardiovascular mortality, myocardial infarction, target vessel revascularization, or stent thrombosis at 1 year). Similarly, rates of major bleeding events did not differ significantly between the groups. CONCLUSION: Early de-escalation of TAT (within 7 days) demonstrated similar clinical outcomes to longer durations (< 7 days). Larger randomized controlled trials are warranted to further validate these findings.
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Kurpad et al. (2026) conducted an observational in Patients requiring oral anticoagulation undergoing percutaneous coronary intervention (PCI) (n=172). Short-duration (< 7 days) triple antithrombotic therapy vs. Extended-duration (≥ 7 but < 28 days) triple antithrombotic therapy was evaluated on Composite endpoint of cardiovascular mortality, myocardial infarction, target lesion revascularization, and definite or probable stent thrombosis at 1 year. Short-duration triple antithrombotic therapy (<7 days) after PCI showed no statistically significant differences in cardiovascular events or major bleeding at 1 year compared to extended duration.
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