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Coronary stent and prolonged dual antiplatelet therapy. A longitudinal study
Cristian A Dámazo-Escobedo1, Gerardo Vieyra-Herrera2, Marco A Martínez-Ríos2
1Higher School of Medicine, Instituto Politécnico Nacional.
Insights
Prolonged dual antiplatelet therapy (DAPT) after stenting is justified. Three-year DAPT showed low bleeding risk and reduced major cardiovascular events, despite high thrombosis-restenosis rates.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Research
Background:
- European guidelines lack consensus on optimal dual antiplatelet therapy (DAPT) duration post-stenting.
- Balancing stent thrombosis-restenosis prevention with bleeding risk is a clinical challenge.
Purpose of the Study:
- To evaluate major bleeding and cardiovascular events with prolonged DAPT.
- Assessed outcomes in patients undergoing primary percutaneous coronary intervention and stenting.
Main Methods:
- A prospective, observational, descriptive study.
- Recruited 135 patients from November 2016 to December 2017.
- Followed patients for three years.
Main Results:
- Mean age was 57 ± 10 years; obesity and hypertension were key risk factors.
- Three-year DAPT resulted in 3.7% mortality, 1.48% major bleeding, and 4.4% thrombosis-restenosis.
- The incidence of thrombosis-restenosis was high.
Conclusions:
- Prolonged DAPT appears justified due to high thrombosis-restenosis rates.
- Significant increase in bleeding risk was not observed.
- Prolonged DAPT demonstrated a decrease in major cardiovascular events.
Introduction:
In current European guidelines for the management of myocardial infarction after coronary stent placement, there is no consensus on dual antiplatelet therapy (DAPT) ideal duration to prevent stent thrombosis-restenosis without significantly increasing the bleeding risk.
Objective:
To report the percentage of major bleeding and presence of major cardiovascular events associated with prolonged DAPT in patients recruited at the National Institute of Cardiology, treated with primary percutaneous coronary intervention and stent.
Methods:
A longitudinal, prospective, observational, non-experimental, descriptive study was carried out. Patients were recruited from November 2016 to December 2017.
Results:
One hundred and thirty-five patients with a mean age of 57 ± 10 years who completed the three-year follow-up were selected. Obesity and hypertension stood out as the main risk factors. After using DAPT for three years, 3.7% of mortality, 1.48% of major bleeding, and 4.4% of thrombosis-restenosis were recorded.
Conclusions:
Prolonged use of DAPT would be justified by the high incidence of thrombosis-restenosis, without a significant increase in bleeding risk, as well as a decrease in major cardiovascular events.
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