Dual antiplatelet therapy >12 months after PCI was not associated with a lower incidence of death or MI compared to therapy ≤12 months (adjusted HR 1.01; 95% CI 0.74 to 1.37; p=0.95).
Observational (n=1,859)
No
Effect estimate: adjusted HR 1.01 (95% CI 0.74 to 1.37)
Absolute Event Rate: 9.4% vs 10.3%
p-value: p=0.95
OBJECTIVE: To assess the impact of dual antiplatelet (DAP) therapy of >12 months on long-term death and myocardial infarction (MI) after percutaneous coronary intervention (PCI). DESIGN, SETTING AND PATIENTS: Prospective, single-centre, observational study of 1859 consecutive patients who underwent successful PCI of a native coronary artery and survived event-free for at least 12 months. MAIN OUTCOME MEASURES: Combined end point of death or non-fatal MI determined by survival analysis and propensity-adjusted multivariable Cox regression. Similar analyses were performed in the two stent subsets: bare metal stents (n = 835), drug-eluting stents (n = 1024); and three high-risk subsets: diabetic patients (n = 486), patients presenting with MI (n = 713), and those with ACC/AHA type C lesions (n = 717). RESULTS: Baseline characteristics were as follows: mean (SD) age 64 (12) years, male 69%, diabetic 26%, presentation with MI 38%, mean (SD) ejection fraction 49 (12)%, mean (SD) vessel diameter 3.1 (0.5) mm. Duration of DAP was 27 (11) months in "DAP >12 months" and 4.1 (4.1) months in "DAP 12 months" vs "DAP 12 months was not associated with lower incidence of death or MI than DAP therapy < or =12 months (adjusted HR = 1.01; 95% CI 0.74 to 1.37, p = 0.95). Analysis of each of the five predefined subsets showed similar results. CONCLUSIONS: In patients who undergo successful native coronary PCI and survive event-free for at least 12 months, continuation of dual antiplatelet therapy beyond 12 months does not confer long-term protection from death or MI.
Harjai et al. (Mon,) conducted a observational in Post-percutaneous coronary intervention (PCI) (n=1,859). Dual antiplatelet (DAP) therapy >12 months vs. DAP therapy ≤12 months was evaluated on Combined end point of death or non-fatal MI (adjusted HR 1.01, 95% CI 0.74 to 1.37, p=0.95). Dual antiplatelet therapy >12 months after PCI was not associated with a lower incidence of death or MI compared to therapy ≤12 months (adjusted HR 1.01; 95% CI 0.74 to 1.37; p=0.95).