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Safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention: A

Anastasios Apostolos1, Dimitrios Chlorogiannis2, Georgios Vasilagkos2

  • 1Department of Cardiology, Faculty of Medicine, University of Patras, University Hospital of Patras, Patras, Greece; First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece.

Hellenic Journal of Cardiology : HJC = Hellenike Kardiologike Epitheorese
|February 3, 2023
PubMed

Insights

Shortened dual antiplatelet therapy (DAPT) for complex percutaneous coronary intervention (PCI) significantly reduces major bleeding events. This approach is safe, with no increase in ischemic events or mortality, offering a feasible option for patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Trials

Background:

  • The optimal duration of dual antiplatelet therapy (DAPT) after complex percutaneous coronary intervention (PCI) is not well-established.
  • This study investigates the safety and efficacy of shortened DAPT (≤3 months) compared to longer durations in patients undergoing complex PCI.

Approach:

  • A systematic review and meta-analysis of five studies involving 9,115 patients was conducted.
  • Data was extracted from MEDLINE, Cochrane Central Register of Controlled Trials, and Scopus.
  • The primary outcome was major bleeding (Bleeding Academic Research Consortium [BARC] 3-5), with secondary outcomes including ischemic events and mortality.

Key Points:

  • Shortened DAPT (≤3 months) significantly reduced major bleeding events by 43% in patients undergoing complex PCI.
  • No significant difference was observed in major adverse cardiovascular events, all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, or stent thrombosis between shortened and longer DAPT durations.
  • The findings support the safety of abbreviated DAPT in this patient population.

Conclusions:

  • Shortened DAPT is a safe and feasible strategy for patients undergoing complex PCI.
  • This approach effectively reduces the risk of major bleeding without compromising cardiovascular outcomes.
  • Further research may refine DAPT duration guidelines for complex PCI cases.
Abstract

Keywords:
BifurcationsChronic total occlusionComplex percutaneous coronary interventionsDual antiplatelet therapyPCI

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