Trade-off for six weeks versus six months of triple Tx post stent
(HealthDay)—For patients receiving oral anticoagulation after drug-eluting stent implantation, six weeks of triple therapy is not superior to six months of therapy with respect to net clinical outcomes, according to a study published in the April 28 issue of the Journal of the American College of Cardiology.
Katrin A. Fiedler, M.D., from the Technische Universität in Munich, and colleagues examined the effect of shortening the duration of clopidogrel therapy from six months to six weeks after drug-eluting stent implantation. A total of 614 patients were randomized to six weeks or six months of clopidogrel therapy.
The researchers found that the primary end point (a composite of death, myocardial infarction, definite stent thrombosis, stroke, or Thrombolysis In Myocardial Infarction major bleeding at nine months) occurred in 9.8 and 8.8 percent of patients in the six-week and six-month groups, respectively (hazard ratio [HR], 1.14; 95 percent confidence interval [CI], 0.68 to 1.91; P = 0.63). No significant differences were seen for the secondary combined ischemic end point (HR, 0.93; 95 percent CI, 0.43 to 2.05; P = 0.87) or the secondary bleeding end point (HR, 1.35; 95 percent CI, 0.64 to 2.84; P = 0.44).
"These results suggest that physicians should weigh the trade-off between ischemic and bleeding risk when choosing the shorter or longer duration of triple therapy," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
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