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DALLAS, November 15, 2020 – A one-month treatment of dual antiplatelet therapy is as safe and effective as longer duration therapy in preventing cardiac events in patients one year after stent placement, according to recent research presented today at the 2020 scientific sessions of the ‘American Heart Association. The virtual meeting will be held from Friday 13 November to Tuesday 17 November 2020 and is a first-rate global exchange of the latest scientific advances, research and updates of evidence-based clinical practice in cardiovascular science for healthcare across the world.
“This study is the first randomized study comparing one-year clinical outcomes of one-month dual antiplatelet therapy followed by aspirin monotherapy to the currently recommended dual antiplatelet therapy regimen in patients with coronary artery disease recovering from stent placement.” said study lead researcher Myeong-Ki Hong, MD, Ph.D., professor of cardiology at Yonsei University College of Medicine, Severance Cardiovascular Hospital in Seoul, Korea.
Patients recovering from arterial opening procedures involving a stent are prescribed one or more antiplatelet drugs (to help keep platelets adherent), usually for months, along with aspirin to prevent blood from clotting in the stent. This is known as dual antiplatelet therapy. Dual antiplatelet therapy, also known as DAPT, can pose a significant risk of bleeding for patients who are already taking blood thinners.
Most studies evaluating a shorter course of DAPT have focused on patients at high risk of bleeding. Additionally, many recent studies have also focused on patients receiving a class of antiplatelet agents known as P2Y12 inhibitor monotherapy rather than aspirin monotherapy after a shorter course of DAPT.
Researchers in this study evaluated and compared the safety and efficacy of two durations of dual antiplatelet therapy in patients who had drug-eluting stent placement or polymer-free drug-coated stent placement and were not at high risk. of bleeding.
In 23 medical centers in Korea, 3,020 Korean patients (mean age 67; 31% female) were randomly assigned to receive:
- one month of dual antiplatelet therapy after placement of a polymer-free drug-coated stent followed by 11 months of aspirin alone;
- o 6-12 months duration of antiplatelet therapy followed by 0-6 months of aspirin alone after the drug eluting stent placement procedure.
Drug-eluting stents are coated with a slowly-releasing polymer designed to reduce the risk of artery obstruction. Polymer-free drug-coated stents are a new type of stent created to address the potential inflammation caused by the polymer.
Most patients (2,969) completed a one-year follow-up. The analysis found that there was no significant difference in the number of cardiac events between the two groups: 5.9% of patients in the one-month treatment group died or had a heart attack, stroke, major bleeding. or stent / angioplasty procedure, compared with 6.5% in the 6 to 12 month treatment group.
“It is encouraging to see that one-month dual antiplatelet therapy followed by aspirin monotherapy after the polymer-free drug-coated stent is effective and safe in a diverse group of patients with coronary heart disease,” Hong said. “These findings could also lead to the suggestion for some patients to discontinue a P2Y12 inhibitor, rather than aspirin, in daily clinical practice, which could result in better patient compliance, lower costs, lower risk of bleeding and, in general. , greater convenience for both patients and doctors. “
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Co-authors are Sung-jin Hong, MD; Jung-sun Kim, MD; Soon Jun Hong, MD; Kyeong Ho Yun, MD; Jong kwan Park, MD; Chul-min Ahn, MD; Byeong-Keuk Kim, MD; Young-Guk Ko, MD; Donghoon Choi, MD; and Yangsoo Jang. The author’s disclosures are in the abstract.
This study is funded by DIO (Korea), Cardinal Health Korea (Korea) and Terumo Corporation (Tokyo, Japan).
Note: session: LBS 05: stents, valves and clots.
Additional Resources:
The multimedia is available in the right column of the release link https: /
What is a stent: See, live and learn
What are anticoagulants and antiplatelet agents?
Understanding your options when taking aspirin and other antiplatelet medications
For more news on AHA Scientific Sessions 2020, follow us on Twitter @HeartNews
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