Review: Short vs. long duration dual antiplatelet Tx after stent

Review: short vs. long duration dual antiplatelet tx after stent

(HealthDay)—Dual antiplatelet therapy (DAPT) continued beyond six months after drug-eluting stent implantation is associated with reduced stent thrombosis and myocardial infarction but also increased bleeding and all-cause mortality as compared to shorter-term DAPT therapy, according to a review published online May 25 in Cardiovascular Therapeutics.

Elsayed Abo-salem, M.D., from the University of Cincinnati, and colleagues conducted a systematic literature review to compare continued use of DAPT with shorter duration DAPT (aspirin alone) for variable durations beyond three months of drug-eluting stent implantation. Data were included from 10 involving 32,136 subjects randomized to continued use of DAPT versus aspirin alone.

The researchers found that longer DAPT correlated with a significant reduction in (0.3 versus 0.7 percent; P < 0.01) and myocardial infarction (1.3 versus 2 percent; P < 0.01) compared with shorter DAPT. Longer DAPT was also associated with a significant increase in major bleeding versus shorter DAPT (0.8 versus 0.4 percent; P < 0.01). No difference was seen in cardiac deaths or stroke. Compared with longer DAPT, shorter DAPT correlated with slightly lower all-cause mortality (odds ratio, 0.8; 95 percent confidence interval, 0.7 to 0.99; P = 0.04).

"DAPT continued beyond six months after second generation drug-eluting stent implantation decreases stent thrombosis and , but increases and all-causes mortality compared to shorter DAPT (aspirin alone)," the authors conclude.

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