Key result
This review discusses recent trials and meta-analyses to identify which high-risk cardiovascular patients might benefit from prolonged dual antiplatelet therapy beyond 12 months post-intervention.
Why the study?
Does prolonged dual antiplatelet therapy (>12 months) reduce thrombo-ischemic events in high-risk cardiovascular patients after stent implantation?
Does prolonged dual antiplatelet therapy (>12 months) reduce thrombo-ischemic events in high-risk cardiovascular patients after stent implantation?
This review synthesizes evidence from recent trials to identify which high-risk patient populations might benefit from prolonged dual antiplatelet therapy beyond 12 months post-PCI.
Recent guidelines suggest dual antiplatelet therapy (DAPT) after 'drug-eluting' stent (DES) implantation for 6 months in stable patients and for 12 months in patients after acute coronary syndrome. Serious complications after stent implantation include stent thrombosis, recurrent myocardial infarction, ischemic stroke, cardiovascular death and bleeding. These complications also occur beyond 1 year after coronary intervention. Thus, it is important to consider whether a prolonged DAPT (>12 months after percutaneous coronary intervention) is of benefit to lower thrombo-ischemic events in high-risk patients. This review addresses the results of recent randomized clinical studies (DAPT, ITALIC, OPTIDUAL and PEGASUS) and meta-analyses to support the author's view of which patient collectives might benefit from prolonged DAPT.
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Tegtmeyer et al. (2018) conducted a review in High-risk cardiovascular patients after percutaneous coronary intervention. Prolonged dual antiplatelet therapy (DAPT) was evaluated. This review discusses recent trials and meta-analyses to identify which high-risk cardiovascular patients might benefit from prolonged dual antiplatelet therapy beyond 12 months post-intervention.
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