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June 27, 2026Journal of Inflammation ResearchOpen Access

Prolonged DAPT beyond 12 months linked to ~65% lower MACCE risk versus conventional therapy.

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Why the study?

The optimal duration of DAPT and its risk-benefit profile in post-PCI patients with high residual inflammatory risk remain unclear.

Does prolonged dual antiplatelet therapy (>12 months) reduce ischemic events compared to conventional therapy (≤12 months) in post-PCI patients with high residual inflammatory risk?

Population

Consecutive post-PCI patients with high residual inflammatory risk (hs-CRP >= 2mg/L) at Fuwai Hospital

Comparison

Prolonged DAPT (> 12 months) vs conventional DAPT (<= 12 months)

Design

Prospective observational study

Follow-up

3 years

Key result

Prolonged dual antiplatelet therapy beyond 12 months significantly reduced the 3-year risk of major adverse cardiac and cerebrovascular events compared to conventional therapy (1.5% vs. 4.2%; adjusted HR 0.347).

Authors

ZWZiyi WangYSYanjun SongZZZe Zheng

Discussion

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Overview

Prolonged DAPT was associated with fewer ischemic events without excess bleeding; leaves open whether randomized trials will confirm benefit post-stenting.

Key Points

  • This research aims to compare the effects of prolonged dual antiplatelet therapy on clinical outcomes in patients with high residual inflammatory risk post-PCI.
  • Prospective observational study at Fuwai Hospital.
  • Patients stratified into prolonged (> 12 months) and conventional (≤ 12 months) DAPT groups.
  • Primary outcome assessed was a composite of all-cause death, myocardial infarction, definite or probable stent thrombosis, or stroke at 3 years.
  • Prolonged DAPT showed a significantly lower risk of the primary outcome (1.5% vs. 4.2%; adjusted HR: 0.347, 95% CI: 0.224–0.539).
  • Net adverse clinical events were also lower with prolonged DAPT (1.4% vs. 4.1%; adjusted HR: 0.338, 95% CI: 0.216–0.53).
  • No significant difference in bleeding rates between DAPT groups (1.0% vs. 1.2%; adjusted HR: 0.793, 95% CI: 0.401–1.57).

Study Design

Type

Observational (n=3,510)

Multicenter

No

Structured PICO

Does prolonged dual antiplatelet therapy (>12 months) reduce ischemic events compared to conventional therapy (≤12 months) in post-PCI patients with high residual inflammatory risk?

P
Population
3,510 post-PCI patients with high residual inflammatory risk (hs-CRP ≥ 2 mg/L) who were event-free at 12 months, followed for 3 years.
E
Exposure
Prolonged dual antiplatelet therapy (aspirin + P2Y12 inhibitor) for > 12 months
C
Comparator
Conventional dual antiplatelet therapy (aspirin + P2Y12 inhibitor) for ≤ 12 months
O
Outcome
Composite endpoint of all-cause death, myocardial infarction, definite or probable stent thrombosis, or stroke at 3 yearscomposite

Main Result

Hazard Ratio: 0.347 (95% CI 0.224–0.539)

Absolute Event Rate: 1.5% vs 4.2%

p-value: p=<0.001

In post-PCI patients with high residual inflammatory risk, extending dual antiplatelet therapy beyond 12 months significantly reduces ischemic events without increasing clinically significant bleeding.

Limitations

  • Observational, non-randomized design precluding causal inferences and limited by selection bias
  • Unbalanced baseline characteristics between groups
  • Only clopidogrel and aspirin were used, limiting extrapolation to more potent P2Y12 inhibitors
  • Based on baseline hs-CRP levels without follow-up measurements
  • Lower-than-expected event rate constraining statistical power
  • Study population defined by PCI procedure rather than underlying clinical diagnosis

Cite This Study

Wang et al. (2026) conducted an observational in Coronary artery disease with high residual inflammatory risk post-PCI (n=3,510). Prolonged dual antiplatelet therapy (>12 months) vs. Conventional dual antiplatelet therapy (≤12 months) was evaluated on Major adverse cardiac and cerebrovascular events (MACCE) at 3 years (adjusted HR 0.347, 95% CI 0.224-0.539, p=<0.001). Prolonged dual antiplatelet therapy beyond 12 months significantly reduced the 3-year risk of major adverse cardiac and cerebrovascular events compared to conventional therapy (1.5% vs. 4.2%; adjusted HR 0.347).

synapsesocial.com/papers/6a3f97bb125782b61d865907https://doi.org/10.2147/jir.s607214
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