DAPT duration ≥7 months was associated with a higher incidence of major bleeding in ACS patients with CKD (aOR 29.7; 95% CI 1.80-491.05), with no significant difference in cardiovascular events.
Cohort (n=4,800)
Yes
Does prolonged dual antiplatelet therapy duration impact cardiovascular and bleeding outcomes in acute coronary syndrome patients with and without chronic kidney disease after percutaneous coronary intervention?
Prolonged dual antiplatelet therapy (≥7 months) in ACS patients with chronic kidney disease after PCI is associated with significantly increased major bleeding without providing additional cardiovascular benefit.
Odds Ratio: 29.7 (95% CI 1.8–491.05)
Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) reduces thrombotic risk in acute coronary syndrome (ACS) but may increase bleeding, especially in chronic kidney disease (CKD). This study evaluated the impact of different DAPT durations on cardiovascular and bleeding outcomes in ACS patients with and without CKD. Using the Taiwan National Health Insurance Research Database (2001-2018), patients ≥20 years with ACS who underwent PCI and received clopidogrel plus aspirin for ≥1 month were analyzed. Primary outcomes were cardiovascular events and bleeding events. Subgroup analysis was conducted by CKD status, which was defined using claims-based International Classification of Diseases, Ninth and Tenth Revision (ICD-9/ICD-10) diagnostic codes. Among 4,800 patients with ACS identified (median age: 62 years; 77% male), there were no significant differences in cardiovascular events across DAPT duration groups. No associations between DAPT duration and cardiovascular outcomes were identified in patients with or without CKD. However, DAPT duration ≥7 months was associated with a higher incidence of other major bleeding in patients with CKD (adjusted odds ratio aOR = 29.7, 95% confidence interval CI: 1.80-491.05,
Chang et al. (Mon,) conducted a cohort in Acute coronary syndrome (n=4,800). DAPT duration ≥7 months vs. Shorter DAPT duration was evaluated on Cardiovascular events and bleeding events (aOR 29.7, 95% CI 1.80-491.05). DAPT duration ≥7 months was associated with a higher incidence of major bleeding in ACS patients with CKD (aOR 29.7; 95% CI 1.80-491.05), with no significant difference in cardiovascular events.