Related Experiment Video

Updated: Oct 20, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.6K

3- or 1-Month DAPT in Patients at High Bleeding Risk Undergoing Everolimus-Eluting Stent Implantation

Roxana Mehran1, Davide Cao1, Dominick J Angiolillo2

  • 1Icahn School of Medicine at Mount Sinai, New York, New York, USA.

JACC. Cardiovascular Interventions
|September 10, 2021
PubMed

Insights

Short dual-antiplatelet therapy (DAPT) of 1 or 3 months was found to be noninferior for ischemic outcomes in high bleeding risk patients undergoing PCI. This abbreviated DAPT approach may also reduce major bleeding events.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Optimal dual-antiplatelet therapy (DAPT) duration for high bleeding risk (HBR) patients undergoing percutaneous coronary intervention (PCI) with current drug-eluting stents is not well-defined.
  • Drug-eluting stents are preferred for HBR patients, necessitating research into safe and effective DAPT strategies.

Purpose of the Study:

  • To evaluate two abbreviated DAPT regimens in HBR patients who have undergone PCI.
  • To compare the safety and efficacy of 1-month and 3-month DAPT versus longer durations.

Main Methods:

  • The XIENCE Short DAPT program comprised three prospective, single-arm studies in HBR patients receiving cobalt-chromium everolimus-eluting stents.
  • Patients received 1-month (XIENCE 28) or 3-month (XIENCE 90) DAPT, discontinuing P2Y12 inhibitors thereafter.
  • Propensity score-stratified analysis was used with historical controls (XIENCE V USA).

Main Results:

  • A total of 3,652 patients were enrolled.
  • 1-month and 3-month DAPT were noninferior to 6-month and 12-month DAPT for ischemic outcomes (all-cause mortality or myocardial infarction).
  • While not significantly reducing BARC types 2-5 bleeding, both abbreviated DAPT durations reduced BARC types 3-5 bleeding; stent thrombosis rates were low (0.2%-0.3%).

Conclusions:

  • Abbreviated DAPT durations of 1 or 3 months are noninferior to longer durations for ischemic outcomes in HBR patients treated with cobalt-chromium everolimus-eluting stents.
  • These shorter DAPT regimens may be associated with reduced major bleeding and maintain a low incidence of stent thrombosis.
Abstract

Keywords:
bleedingeverolimus-eluting stenthigh bleeding riskpercutaneous coronary interventionshort DAPTthrombosis

More Related Videos

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

25.8K
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.4K

Related Concept Videos

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
764
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
71
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
66
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
36
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
60
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
52