After PCI and short-term DAPT, P2Y12 inhibitors alone vs. ongoing DAPT reduce major bleeding; CV events do not differ

Area of Science:

• Cardiology
• Interventional Cardiology
• Pharmacology

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
• Dual antiplatelet therapy (DAPT) is frequently used post-PCI to prevent stent thrombosis.
• Concerns exist regarding bleeding risks associated with DAPT.

Purpose of the Study:

• To compare the efficacy and safety of DAPT versus P2Y12 inhibitor monotherapy in patients after PCI.
• To evaluate the impact on major adverse cardiovascular events (MACE) and bleeding.

Main Methods:

• A meta-analysis of randomized controlled trials was conducted.
• Studies included patients undergoing PCI who received either DAPT or P2Y12 inhibitor monotherapy.
• Outcomes assessed included MACE and bleeding events.

Main Results:

• Dual antiplatelet therapy (DAPT) did not show a significant reduction in major adverse cardiovascular events (MACE) compared to P2Y12 inhibitor monotherapy.
• No significant difference in the incidence of stent thrombosis was observed between the two groups.
• Patients receiving P2Y12 inhibitor monotherapy experienced significantly lower rates of bleeding events.

Conclusions:

• P2Y12 inhibitor monotherapy is a viable and potentially safer alternative to DAPT in select patients after percutaneous coronary intervention.
• The findings support a de-escalation strategy to minimize bleeding complications without compromising ischemic protection.