Why the study?
Current recommendations on DAPT duration after ACS are largely based on Western data and may not reflect the clinical profile of Indian patients, necessitating region-specific guidance.
Does serial echocardiographic surveillance with EF and GLS reveal discordant patterns of early myocardial dysfunction in oncology patients?
Cohort (n=117)
Does serial echocardiographic surveillance with EF and GLS reveal discordant patterns of early myocardial dysfunction in oncology patients?
p-value: p=0.27
EF and GLS frequently exhibit discordant patterns of deterioration during early cancer therapy surveillance, emphasizing the clinical value of integrating multiple echocardiographic parameters to detect individual-level cardiotoxicity.
Discordance between EF and GLS deterioration cautions against single-parameter reliance for early cardiotoxicity; leaves open optimal multiparametric integration in prospective oncology cohorts.
Background: The optimal duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome (ACS) continues to evolve, but current recommendations derived largely from Western data may not reflect the clinical profile of Indian patients, underscoring the need for region-specific guidance. Objective: To develop consensus-based, India-specific recommendations on DAPT duration in ACS by integrating global evidence with real-world clinical considerations. Materials and Methods: A modified Delphi process was conducted among experienced interventional cardiologists across India. Participants reviewed evidence summaries and anonymously rated ten statements on prolonged, shortened, and risk-stratified DAPT strategies. Consensus was defined as ≥75% agreement. Results: All 34 cardiologists completed the survey (100% response). Consensus (≥≥70%) was achieved for all statements. Strong agreement supported prolonged DAPT in high-thrombotic-risk ACS (97.1%) and balancing ischemic and bleeding risks (94.1%). Agreement with the ESC 6-month DAPT recommendation for stable DES percutaneous coronary intervention (PCI) was lower (61.8%), reflecting preference for extended therapy in Indian practice. While short DAPT reduced bleeding (85.3%), most experts acknowledged higher MI risk in ACS, consistent with SMART-DATE and STOPDAPT-2 ACS (79.4%). Prolonged DAPT (≥≥12 months) in complex PCI received strong support (97%), with universal agreement that it reduces MACE and cardiothrombotic events (100%). Key factors favoring extended therapy included smoking and prior MI/stent thrombosis (97% each), as well as procedural complexity. Routine PPI cotherapy was endorsed by 79.4%. Conclusion: The GOLD-DAPT consensus offers practical, risk-adapted recommendations for Indian ACS patients, supporting individualized rather than fixed-duration DAPT and emphasizing the need for India-specific prospective data to guide future national policy.
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Desai et al. (2026) conducted a cohort in Cancer therapy-related cardiac dysfunction (n=117). Oncologic therapy (anthracycline-based and/or HER2-targeted) was evaluated on Concordance between clinically relevant left ventricular ejection fraction (EF) and global longitudinal strain (GLS) deterioration (p=0.27).
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