Key result
One-month dual antiplatelet therapy followed by clopidogrel monotherapy resulted in similar rates of ischemic events (1.9% vs 1.8%) and bleeding events (0.4% vs 0.5%) at 1 year compared to 3-month therapy followed by aspirin.
Why the study?
Does shortened DAPT duration (1-3 months) reduce bleeding events without increasing ischemic events compared to standard DAPT in patients after PCI with new-generation DES?
Does shortened DAPT duration (1-3 months) reduce bleeding events without increasing ischemic events compared to standard DAPT in patients after PCI with new-generation DES?
Absolute Event Rate: 1.9% vs 1.8%
Shortening DAPT to 1-3 months after PCI with new-generation DES reduces bleeding events while maintaining ischemic safety compared to standard 6-12 month durations.
efficacy of 3-month DAPT followed by aspirin monotherapy after successful PCI with cobalt-chromium everolimuseluting stent (CoCr-EES).3 The result showed that 3-month DAPT after CoCr-EES implantation was at least as safe as the prolonged DAPT in both aspects of bleeding and ischemic events.STOPDAPT-2 was a prospective and randomized trial comparing the efficacy of 1-month DAPT followed by clopidogrel monotherapy with 12-month DAPT after CoCr-EES implantation.4 The results showed that 1-month DAPT followed by clopidogrel monotherapy compared with 12-month DAPT resulted in a significantly lower rate of a composite of cardiovascular and bleeding T he appropriate duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) has been evaluated and debated in many clinical trials worldwide.The development of new-generation drug-eluting stent (DES) enabled to safely shorten the duration of DAPT after PCI. 1 However, the optimal duration of DAPT after PCI is not fully understood.The current guidelines of European Society of Cardiology (ESC) recommend 6-month DAPT after PCI in patients with stable angina. 2 On the other hand, 3-month DAPT is recommended in patients with high bleeding risk.Recently, it becomes mainstream to shorten the duration of DAPT after PCI to prevent bleeding events while controlling ischemic events.STOPDAPT-1 was a prospective trial evaluating the
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Hiroaki Yokoyama (2020) conducted an editorial in Percutaneous coronary intervention (PCI). 1-month DAPT followed by clopidogrel monotherapy vs. 3-month DAPT followed by aspirin monotherapy was evaluated on Ischemic events (composite of cardiovascular death, myocardial infarction, stroke and stent thrombosis) at 1 year. One-month dual antiplatelet therapy followed by clopidogrel monotherapy resulted in similar rates of ischemic events (1.9% vs 1.8%) and bleeding events (0.4% vs 0.5%) at 1 year compared to 3-month therapy followed by aspirin.
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