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October 1, 2015Baylor University Medical Center ProceedingsOpen Access

Dual Antiplatelet Compared to Triple Antithrombotic Therapy in Anterior Wall Acute Myocardial Infarction Complicated by Depressed Left Ventricular Ejection Fraction

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Why the study?

Does dual antiplatelet therapy compared to triple antithrombotic therapy prevent thromboembolic events and reduce bleeding in patients post-PCI for anterior STEMI with LVEF ≤35%?

Population

124 patients who received percutaneous coronary intervention for anterior ST elevation myocardial infarction…

Comparison

Dual antiplatelet therapy (DAPT) vs Triple antithrombotic therapy consisting of…

Design

Cohort

Key result

Dual antiplatelet therapy was associated with similar rates of thromboembolic events (5% vs 6.8%, P=0.70) and bleeding (2.5% vs 9.1%, P=0.18) compared to triple therapy after PCI for anterior STEMI.

Authors

OOOla O. OyetayoKSKipp SlickerLRLisa De La Rosa

Discussion

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Member takes

Overview

May favor DAPT to limit bleeding without excess thromboembolism in anterior STEMI with low EF; leaves open randomized confirmation.

Study Design

Type

Cohort (n=124)

Structured PICO

Does dual antiplatelet therapy compared to triple antithrombotic therapy prevent thromboembolic events and reduce bleeding in patients post-PCI for anterior STEMI with LVEF ≤35%?

P
Population
124 patients who received PCI for anterior STEMI with extensive wall motion abnormality and ejection fraction ≤35%, without known left ventricular thrombus.
E
Exposure
Dual antiplatelet therapy (DAPT)
C
Comparator
Triple antithrombotic therapy (TT) consisting of warfarin, aspirin, and a P2Y12 inhibitor
O
Outcome
Rates of thromboembolic and bleeding eventshard clinical

Main Result

Absolute Event Rate: 5% vs 6.8%

p-value: p=0.70

In patients with anterior STEMI and LVEF ≤35% undergoing PCI, DAPT showed similar rates of thromboembolic events and numerically lower bleeding compared to triple therapy, challenging the routine use of warfarin in this population.

Cite This Study

Oyetayo et al. (2015) conducted a cohort in Anterior STEMI with depressed LVEF (n=124). Dual antiplatelet therapy (DAPT) vs. Triple antithrombotic therapy (TT) was evaluated on Thromboembolic events (p=0.70). Dual antiplatelet therapy was associated with similar rates of thromboembolic events (5% vs 6.8%, P=0.70) and bleeding (2.5% vs 9.1%, P=0.18) compared to triple therapy after PCI for anterior STEMI.

synapsesocial.com/papers/6a542e42626008a95bd6490ahttps://doi.org/10.1080/08998280.2015.11929303
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