Key result
Switching from dual antiplatelet therapy to aspirin monotherapy at 3 months after zotarolimus-eluting stent implantation reduced bleeding events compared to 12-month DAPT (1.5% vs 11.5%, P<0.05).
Why the study?
Does discontinuing DAPT at 3 months reduce bleeding without increasing MACE compared to 12 months of DAPT in CAD patients after ZES implantation?
Cohort (n=128)
Does discontinuing DAPT at 3 months reduce bleeding without increasing MACE compared to 12 months of DAPT in CAD patients after ZES implantation?
Absolute Event Rate: 1.5% vs 11.5%
p-value: p=<0.05
Discontinuing DAPT at 3 months after ZES implantation significantly reduces bleeding risk without increasing the risk of stent thrombosis or MACE compared to conventional 12-month DAPT.
Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention increases the risk of bleeding. We studied the safety and clinical outcomes of switching from DAPT to aspirin monotherapy at 3 months after ZES implantation. We retrospectively evaluated 168 consecutive patients with coronary artery disease who had been implanted with a ZES from June 2009 through March 2010. After excluding 40 patients according to exclusion criteria such as myocardial infarction, 128 patients were divided into a 3-month DAPT group (67 patients, 88 lesions) and a 12-month conventional DAPT group (61 patients, 81 lesions). Coronary angiographic followup and clinical followup were conducted at more than 8 months and at 12 months after ZES implantation, respectively. Minor and major bleeding events, stent thrombosis (ST), and major adverse cardiac events (MACE) (death, myocardial infarction, cerebrovascular accident, target lesion revascularization, and target vessel revascularization) were evaluated. There were no statistically significant differences in the incidences of ST and MACE between the two groups. The incidence of bleeding events was significantly lower in the 3-month group than in the 12-month group (1.5% versus 11.5%, P < 0.05). DAPT can be safely discontinued at 3 months after ZES implantation, which reduces bleeding risk.
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Wada et al. (2013) conducted a cohort in Coronary artery disease (n=128). 3-month dual antiplatelet therapy (DAPT) vs. 12-month conventional DAPT was evaluated on Bleeding events (p=<0.05). Switching from dual antiplatelet therapy to aspirin monotherapy at 3 months after zotarolimus-eluting stent implantation reduced bleeding events compared to 12-month DAPT (1.5% vs 11.5%, P<0.05).
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