Key result
Clopidogrel plus aspirin is preferred for post-PCI DAPT by ~58% of surveyed clinicians.
Why the study?
Optimal DAPT duration and agent choice post-PCI remain debated in Indian clinical practice, prompting this evaluation of real-world clinician perspectives on DAPT optimization and aspirin-clopidogrel fixed-dose combinations.
Cross-Sectional (n=301)
Yes
This nationwide survey of Indian clinicians reveals that aspirin plus clopidogrel remains the dominant post-PCI DAPT regimen (57.8%), with significant specialty and regional variations in treatment duration that underscore the need for India-specific clinical guidelines.
Indian clinicians show varied post-PCI DAPT durations and agents; leaves open need for prospective trials to guide standardization.
Background: Background: Dual antiplatelet therapy (DAPT) is post-percutaneous coronary intervention (PCI) to prevent thrombotic events. However, optimal duration and agent choice remain debated, particularly in Indian practice. This study explored real-world clinician perspectives on DAPT optimization and the use of aspirin–clopidogrel fixed-dose combinations (FDCs). Methods: The INDI-PROLONG study was an anonymous, cross-sectional PAN India survey conducted between June 15 and August 15, 2024. A total of 301 clinicians, including cardiologists, consulting physicians, diabetologists, and other specialists, participated. The survey assessed DAPT prescription patterns, preferred regimens, determinants of duration, and perceptions of aspirin–clopidogrel FDCs. Results: Of 301 clinicians, 259 (86.1%) routinely prescribed DAPT post-PCI. For high thrombotic risk patients, 165 (54.8%) favored >12 months of therapy, while 136 (45.2%) recommended 12 months. Clopidogrel + aspirin was most preferred (57.8%), followed by ticagrelor + aspirin (23.9%) and prasugrel + aspirin (15.6%). Clopidogrel was prescribed to 25–50% of eligible patients by 137 (45.5%) clinicians. Key factors influencing duration included bleeding risk (48.8%), guideline recommendations (39.5%), adherence (36.5%), and thrombotic risk (32.2%). Switching from ticagrelor to clopidogrel was mainly due to bleeding (56.5%) and adverse reactions (30.6%). Cardiologists favored prolonged therapy, while consulting physicians preferred standard 12-month durations. Regional variation was noted, with northern India showing a higher preference for extended DAPT. Conclusion: Indian clinicians demonstrate varied DAPT strategies, balancing efficacy, safety, and accessibility. Clopidogrel + aspirin remains the dominant choice. Findings highlight the need for India-specific guidelines to optimize DAPT duration and agent selection based on real-world evidence.
No takes yet. Share an insight, caveat, or question.
Bansal et al. (2026) conducted a cross-sectional in Post-percutaneous coronary intervention (PCI) secondary prevention (n=301). Dual antiplatelet therapy (DAPT) prescription practices and clopidogrel + aspirin utilization vs. Alternative DAPT regimens (ticagrelor + aspirin, prasugrel + aspirin) and varying therapy durations was evaluated on Clinician preference for most preferred DAPT combination post-PCI (Clopidogrel + Aspirin vs Ticagrelor + Aspirin) (p=<0.001). Clopidogrel plus aspirin was the most preferred post-PCI DAPT regimen among 57.8% of Indian clinicians, with 86.1% routinely prescribing DAPT and 54.8% favoring >12 months for high thrombotic risk.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: