Key result
ACS is not associated with higher 1-year major event risk than stable CAD following 3-month DAPT.
Why the study?
No previous prospective study had evaluated 3-month dual antiplatelet therapy after cobalt-chromium everolimus-eluting stent implantation in patients with acute coronary syndrome.
Is 3-month dual antiplatelet therapy after CoCr-EES implantation as safe in patients with acute coronary syndrome as in those with stable coronary artery disease?
Cohort (n=1,525)
Yes
Is 3-month dual antiplatelet therapy after CoCr-EES implantation as safe in patients with acute coronary syndrome as in those with stable coronary artery disease?
Hazard Ratio: 0.94 (95% CI 0.44–1.87)
Absolute Event Rate: 2.3% vs 3%
p-value: p=0.87
Stopping DAPT at 3 months after CoCr-EES implantation in ACS patients appears as safe as in stable CAD patients, with no definite or probable stent thrombosis observed at 1 year.
No takes yet. Share an insight, caveat, or question.
Short DAPT post-CoCr-EES warrants no differential caution in ACS versus stable CAD; leaves open randomized confirmation of safety.
Natsuaki et al. (2020) conducted a cohort in Acute coronary syndrome and stable coronary artery disease (n=1,525). Acute coronary syndrome (ACS) vs. Stable coronary artery disease (CAD) was evaluated on Composite of cardiovascular death, myocardial infarction, stroke, definite stent thrombosis, and TIMI major/minor bleeding at 1 year (HR 0.94, 95% CI 0.44-1.87, p=0.87). Acute coronary syndrome was not associated with a significantly higher 1-year risk of the primary composite endpoint compared to stable coronary artery disease in patients receiving 3-month dual antiplatelet therapy after everolimus-eluting stent implantation (2.3% vs 3.0%, adjusted HR 0.94).
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