(HealthDay)—In patients receiving drug-eluting stents, dual antiplatelet therapy can be safely discontinued during the first year, according to two studies published online Sept. 19 in the Journal of the American College of Cardiology.
In the first study, Ignacio Ferreira-González, M.D., Ph.D., from Vall d'Hebron Hospital in Barcelona, Spain, and colleagues conducted a study involving 1,622 patients undergoing drug-eluting stent implantation. The patients were assessed at regular intervals up to a year post-implantation. During that time, 10.6 percent interrupted at least one antiplatelet drug; 64.5 percent of the interruptions were temporary. The researchers found that the rate of major cardiac events was similar in patients who continued or interrupted treatment.
In the second study, Byeong-Keuk Kim, M.D., from the Yonsei University College of Medicine in Seoul, South Korea, and colleagues randomly assigned 2,117 patients with coronary artery stenosis to receive a zotarolimus-eluting stent with three months of dual antiplatelet therapy or another drug-eluting stent with twelve months of dual antiplatelet therapy. The researchers found that both groups had similar rates of a primary composite end point of cardiovascular death, myocardial infarction, stent thrombosis, target or vessel revascularization, or bleeding at one year (4.7 percent in each group).
"With newer-generation drug-eluting stents, six months [of] dual antiplatelet therapy might be sufficient, and three months not completely off-the-wall in low-risk groups," Bernhard Witzenbichler, M.D., from Charité-Campus Benjamin Franklin in Berlin, writes in an accompanying editorial. "However, the patient- and device-related criteria safely allowing early dual antiplatelet therapy withdrawal or interruption still have to be determined."
The Ferreira-González study was partially funded by Bristol-Myers Squibb; two authors disclosed financial ties to drug and device companies. Two authors from the Kim study disclosed financial ties to Medtronic.
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Abstract - Ferreira-González
Abstract - Kim