Key result
Dual antiplatelet therapy did not significantly reduce 30-day net clinical adverse events compared to single antiplatelet therapy in AMI patients with thrombocytopenia (HR 0.67; 95% CI 0.40-1.10).
Why the study?
Does dual antiplatelet therapy reduce net clinical adverse events in medically treated acute myocardial infarction patients with baseline thrombocytopenia compared to single antiplatelet therapy?
Cohort (n=468)
Yes
Does dual antiplatelet therapy reduce net clinical adverse events in medically treated acute myocardial infarction patients with baseline thrombocytopenia compared to single antiplatelet therapy?
Hazard Ratio: 0.67 (95% CI 0.4–1.1)
Absolute Event Rate: 14.26% vs 24.11%
p-value: p=0.1145
In patients with medically treated AMI and baseline thrombocytopenia, DAPT did not significantly reduce 30-day net clinical adverse events compared to SAPT.
Background: /uL) are unclear. Methods: In this multi-institute retrospective cohort study, we included 468 patients with medically treated AMI with baseline thrombocytopenia and separated them into single antiplatelet therapy (SAPT) and DAPT groups according to the discharge anti-thrombotic strategy. The primary outcome was net clinical adverse events (NACEs), defined as a composite of death, ischemic events (myocardial infarction, ischemic stroke, and transient ischemic attack), and major bleeding within 30 days. Results: There were 168 patients in the SAPT group (100 taking aspirin and 68 taking clopidogrel) and 300 in the DAPT group. A primary outcome occurred in 35 (24.11 per 100 patient-months) patients in the SAPT group and 39 (14.26 per 100 patient-months) patients in the DAPT group [adjusted hazard ratio (HR): 0.67; 95% confidence interval (CI): 0.40-1.10; p = 0.1145]. Kaplan-Meier curves showed favorable results in the DAPT group (log-rank p = 0.0243). Bleeding events occurred in 18 (10.71 per 100 patient-months) patients in the SAPT group and 18 (6.40 per 100 patient-months) patients in the DAPT group (adjusted HR: 0.66; 95% CI: 0.32-1.36; p = 0.2573). Conclusions: DAPT versus SAPT as discharge anti-thrombotic strategy in thrombocytopenic patients with medically treated AMI did not significantly improve NACEs at 30 days. However, there was a trend towards favorable outcomes in the DAPT group. These results should be interpreted carefully with respect to the relatively limited trial population and study design.
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Lu et al. (2022) conducted a cohort in Acute Myocardial Infarction with baseline thrombocytopenia (n=468). Dual antiplatelet therapy (DAPT) vs. Single antiplatelet therapy (SAPT) was evaluated on Net clinical adverse events (NACEs), defined as a composite of death, ischemic events (myocardial infarction, ischemic stroke, and transient ischemic attack), and major bleeding within 30 days (HR 0.67, 95% CI 0.40-1.10, p=0.1145). Dual antiplatelet therapy did not significantly reduce 30-day net clinical adverse events compared to single antiplatelet therapy in AMI patients with thrombocytopenia (HR 0.67; 95% CI 0.40-1.10).
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