Key result
Short DAPT cuts major bleeding without increasing ischemic events in high-bleeding-risk PCI patients.
Why the study?
To review the clinical outcomes of different antithrombotic strategies in patients with high bleeding risk after percutaneous coronary intervention.
Does a shorter duration of DAPT reduce major bleeding without increasing ischemic events in patients with high bleeding risk after PCI?
Does a shorter duration of DAPT reduce major bleeding without increasing ischemic events in patients with high bleeding risk after PCI?
Shorter DAPT regimens of 1-3 months post-PCI improve safety by reducing major bleeding in high-risk patients without a penalty in ischemic outcomes.
Answers are grounded in this paper and cite their sources.
May support 1-3 month DAPT post-PCI in high bleeding risk; leaves open need for dedicated long-term RCTs.
PURPOSE OF REVIEW: Review the clinical outcomes of different antithrombotic strategies in patients with high bleeding risk (HBR) after percutaneous coronary intervention (PCI). RECENT FINDINGS: Patients with HBR after PCI include those with advanced age (e.g. >75 years of age), a prior history of major bleeding, anemia, chronic kidney disease, and those with indications for long-term anticoagulation. Strategies that successfully decrease bleeding risk in this population include shorter durations of dual antiplatelet therapy (DAPT; of 1-3 months) followed by single antiplatelet therapy with aspirin or a P2Y 12 inhibitor, or de-escalating from a more potent P2Y 12 inhibitor (prasugrel or ticagrelor) to less potent antiplatelet regimens (aspirin with clopidogrel or half-dose ticagrelor or half-dose prasugrel). Patients on DAPT, and a full dose anticoagulation for other indications, have a lower risk of major bleeding without an increase in 1-2-year adverse ischemic events, when rapidly switched from DAPT to a single antiplatelet therapy (within a week after PCI) with aspirin or clopidogrel. Longer term data on the benefits and risks of these strategies is lacking. SUMMARY: In patients with HBR after PCI, shorter durations of DAPT (1-3 months) decrease the risk of major bleeding without increasing the risk of adverse ischemic events.
No takes yet. Share an insight, caveat, or question.
Almarzooq et al. (2023) conducted a review in High bleeding risk (HBR) after percutaneous coronary intervention (PCI). Shorter durations of dual antiplatelet therapy (DAPT) vs. Standard duration DAPT was evaluated on Major bleeding and adverse ischemic events. In patients with high bleeding risk after PCI, shorter durations of DAPT (1-3 months) decrease the risk of major bleeding without increasing the risk of adverse ischemic events.
Synapse has enriched 10 related papers. Consider them for comparative context: