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July 28, 2023Current Opinion in CardiologyOpen Access

Antithrombotic treatment following percutaneous coronary intervention in patients with high bleeding risk

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Key result

1-3 months of DAPT reduces major bleeding without increasing ischemic events in HBR patients post-PCI.

Why the study?

To review the clinical outcomes of different antithrombotic strategies in patients with high bleeding risk after percutaneous coronary intervention.

Do shorter durations of DAPT or de-escalation strategies decrease bleeding risk without increasing ischemic events in patients with high bleeding risk after PCI?

Population

Patients with high bleeding risk after PCI

Comparison

Different antithrombotic strategies

Design

Review

Authors

ZAZaid AlmarzooqNANora Al-RoubSKScott Kinlay

Discussion

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Member takes

Overview

Supports shorter DAPT in high-bleeding-risk post-PCI patients; leaves open need for dedicated RCTs to confirm safety.

Structured PICO

Do shorter durations of DAPT or de-escalation strategies decrease bleeding risk without increasing ischemic events in patients with high bleeding risk after PCI?

P
Population
Patients with high bleeding risk undergoing percutaneous coronary intervention.
I
Intervention
Shorter durations of dual antiplatelet therapy (DAPT; 1-3 months) followed by single antiplatelet therapy, de-escalation of P2Y12 inhibitors, or rapid switch from DAPT to single antiplatelet therapy in patients on full dose anticoagulation.
O
Outcome
Major bleeding and adverse ischemic events

Shorter durations of DAPT (1-3 months) or de-escalation strategies are effective in reducing major bleeding without increasing ischemic risk in high bleeding risk patients after PCI.

Limitations

  • Longer term data on the benefits and risks of these strategies is lacking.

Cite This Study

Almarzooq et al. (2023) conducted a review in High bleeding risk after percutaneous coronary intervention. Shorter durations of dual antiplatelet therapy (1-3 months) or de-escalation vs. Standard/longer duration DAPT was evaluated on Major bleeding and adverse ischemic events. Shorter durations of dual antiplatelet therapy (1-3 months) decrease the risk of major bleeding without increasing adverse ischemic events in patients with high bleeding risk after PCI.

synapsesocial.com/papers/6a2391c2f11d41932608cb1dhttps://doi.org/10.1097/hco.0000000000001075
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