Background: Optimal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) remains controversial.
Aim: We investigated the relationship between DAPT duration following PCI and long-term ischemic and bleeding outcomes under real-world conditions.
Methods: Patients aged ≥ 65 years who underwent PCI with stenting in Western Australian hospitals between 2003 and 2008 and survived 2 years were identified from linked hospital admissions data. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE) defined as a composite of all-cause death and admissions for acute coronary syndrome (ACS), coronary artery revascularization procedure, stroke, and major bleeding. Secondary outcomes were ACS admissions, all-cause death, and major bleeding admissions. Patients were followed up for 5 years from initial PCI.
Results: A total of 3963 patients were included in the final analysis. The mean age of the cohort was 74.5 ± 6.1 years with 67.3% males. No significant difference was seen with 6-12, 12-18, or 18-24 months DAPT, compared to 0-6 months DAPT duration for MACCE and all secondary outcomes at 3- and 5-year post-PCI.
Conclusion: There is no significant difference in both bleeding and ischemic outcomes in long-term DAPT as compared to short-term DAPT for first- and second-generation drug-eluting stents in a real-world population.
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http://dx.doi.org/10.1007/s11845-022-03171-y | DOI Listing |
J Endovasc Ther
January 2025
Department of Vascular Surgery, Northwest Hospital Group, Alkmaar, The Netherlands.
Objective: There is a lack of consensus regarding the optimal antithrombotic therapy (ATT) after popliteal and infrapopliteal (PIP) endovascular therapy (EVT). Currently, dual antiplatelet therapy (DAPT) for 3 months and single antiplatelet therapy (SAPT) are the most prescribed regimens in the Netherlands. Thus far, no randomized comparison has been performed on the optimal ATT approach.
View Article and Find Full Text PDFEur J Neurol
January 2025
Department of Neurology, St. John's Hospital, Vienna, Austria.
Background And Purpose: Three large, randomized trials demonstrated the benefit of short-term dual antiplatelet therapy (DAPT) versus monotherapy after non-cardioembolic minor stroke or high-risk transient ischemic attack (TIA). The aim of this study was to evaluate effects of DAPT versus monotherapy on functional outcomes and safety in a real-life setting.
Methods: Patients with minor stroke (NIHSS <4) or high-risk TIA (ABCD2 score ≥4) of non-cardioembolic origin without major vessel occlusion or revascularization therapy (thrombolysis or thrombectomy) treated between 2018 and 2023 were analyzed based on a prospective nationwide stroke unit registry.
J Korean Med Sci
December 2024
Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea.
Background: The optimal duration and net clinical benefit of dual antiplatelet therapy (DAPT) after transcatheter aortic valve replacement (TAVR) have not been elucidated in real-world situations.
Methods: Using nationwide claims data from 2013 to 2021, we selected patients who underwent TAVR and categorized them into two groups: short- and long-term (≤ 3 and > 3 months, respectively) DAPT group. Propensity score matching was used to balance baseline characteristics.
Stroke
December 2024
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy (M.F., E.D.M., F.D.S., F. Pistoia, R.O., S.S.).
Background: Sex may impact clinical outcomes in patients with stroke treated with dual antiplatelet therapy (DAPT). We aimed to investigate the sex differences in the short-term outcomes of DAPT within a real-world population of patients with noncardioembolic mild-to-moderate ischemic stroke or high-risk transient ischemic attack.
Methods: We performed a propensity score-matched analysis from a prospective multicentric cohort study (READAPT [Real-Life Study on Short-Term Dual Antiplatelet Treatment in Patients With Ischemic Stroke or Transient Ischemic Attack]) by including patients with noncardioembolic mild-to-moderate stroke (National Institutes of Health Stroke Scale score of 0-10) or high-risk transient ischemic attack (age, blood pressure, clinical features, duration of transient ischemic attack, presence of diabetes [ABCD] ≥4) who initiated DAPT within 48 hours of symptom onset.
Int J Stroke
December 2024
Department of Brain Sciences, Imperial College London, London, UK.
Background: According to the literature, about one third of patients with brain ischemic symptoms lasting <24 h, which are classified as Transient ischemic attacks (TIAs) according to the traditional "time-based" definition, show the presence of acute ischemic lesions at neuroimaging. Recent evidence has shown that the presence of acute ischemic lesions at neuroimaging may impact on the outcome of patients with transient ischemic symptoms treated with dual antiplatelet treatment (DAPT). This uncertainty is even more compelling in recent years as short-term DAPT has become the standard treatment for any non-cardioembolic TIA or minor ischemic stroke.
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