Key result
DAPT cuts platelet reactivity index ~56% vs. aspirin monotherapy, though ~28% show resistance.
Why the study?
The prevalence and variability of antiplatelet resistance among patients undergoing intracoronary stent implantation treated with dual antiplatelet therapy were not well characterized.
Does dual antiplatelet therapy with aspirin and thienopyridine affect platelet reactivity compared to aspirin monotherapy in patients undergoing intracoronary stent implantation?
Population
32 patients undergoing intracoronary stent implantation
Comparison
Aspirin + thienopyridine dual therapy vs aspirin monotherapy
Design
Open prospective study
Follow-up
7 days
Authors
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May support dual therapy for greater platelet inhibition in some patients; leaves open non-responder identification and outcome trials.
RCT (n=52)
Open-label
Randomized
No
Does dual antiplatelet therapy with aspirin and thienopyridine affect platelet reactivity compared to aspirin monotherapy in patients undergoing intracoronary stent implantation?
Absolute Event Rate: 37.6% vs 85.08%
p-value: p=<0.001
A significant proportion (28%) of patients undergoing stent implantation exhibit insufficient antiplatelet response to dual therapy with aspirin and thienopyridine at 7 days.
Djukanović et al. (2008) conducted an RCT in Ischemic heart disease undergoing elective percutaneous coronary intervention (n=52). Aspirin + thienopyridine (ticlopidine or clopidogrel) vs. Aspirin monotherapy was evaluated on Platelet reactivity index (PRI) after 7 days of treatment (p=<0.001). Dual antiplatelet therapy with aspirin and a thienopyridine significantly decreased the platelet reactivity index compared to aspirin monotherapy, though 28% of patients exhibited insufficient antiplatelet response after 7 days.
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