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Fixed-Dose Antiplatelet Dual Combination in Patients with Coronary Artery Disease in Turkish Population: DAPT-TR
Ahmet Öz1, Kenan Toprak2, Ertan Aydin3
1Department of Cardiology, Health Science University, Istanbul Training and Research Hospital, Istanbul - Turquia.
Insights
Fixed-dose dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is effective and safe for acute and chronic coronary syndromes, demonstrating low rates of major adverse cardiovascular events and bleeding. This DAPT regimen supports patient outcomes in coronary syndromes.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- Dual antiplatelet therapy (DAPT) is standard for coronary syndromes, reducing mortality and thrombotic events.
- Balancing ischemic burden and bleeding risk is key for optimal DAPT selection and duration.
- Fixed-dose combination therapy offers a standardized approach to DAPT.
Purpose of the Study:
- To prospectively evaluate the clinical outcomes of patients on fixed-dose aspirin (75 mg) + clopidogrel (75 mg) therapy.
- To assess the safety and efficacy of this DAPT regimen in a real-world cohort.
- To analyze rates of major adverse cardiovascular events and bleeding complications.
Main Methods:
- A multicentric, cross-sectional, observational cohort study of 1500 patients with acute or chronic coronary syndrome.
- Patients received fixed-dose combination DAPT (aspirin 75 mg + clopidogrel 75 mg).
- Primary endpoints included hospitalization, myocardial infarction, stent thrombosis, TVR, and bleeding (BARC criteria); secondary endpoints included death and stroke.
Main Results:
- Median age was 63 years; 78.5% had acute coronary syndrome.
- Cardiovascular hospitalization: 7.9%; acute myocardial infarction: 2.3%; stent thrombosis: 1.3%; target-vessel revascularization: 4.2%.
- Bleeding Academic Research Consortium (BARC) type 1 bleeding: 3.3%; BARC types 2, 3, or 5 bleeding: 0.6%. All-cause mortality: 0.5%; cardiovascular death: 0.3%; stroke: 0.3%.
Conclusions:
- Fixed-dose aspirin (75 mg) + clopidogrel (75 mg) combination therapy demonstrates effectiveness in managing acute and chronic coronary syndromes.
- The DAPT regimen shows a favorable safety profile with low rates of major adverse cardiovascular events and clinically significant bleeding.
- This fixed-dose DAPT is a safe and effective option for appropriately selected patients with coronary syndromes.
Background:
Dual antiplatelet therapy (DAPT) is the treatment of choice for patients with acute and chronic coronary syndromes as it reduces mortality and prevents recurrent thrombotic complications. The assessment of both ischaemic burden and bleeding risk is crucial in deciding which DAPT to choose and how long it should be continued.
Objectives:
The aim of our study was to perform prospective clinical follow-up of patients receiving fixed-dose combination therapy (ASA 75 mg + clopidogrel 75 mg). Our study is a multicentric, cross-sectional, observational, cohort study.
Methods:
A total of 1500 patients who were started on fixed-dose combination DAPT for acute or chronic coronary syndrome were included in the study. Primary endpoints were hospitalization for any reason, hospitalization for cardiovascular cause, acute myocardial infarction, stent thrombosis, target vessel revascularization and bleeding; the secondary endpoints were death for any reason or cardiovascular cause and stroke. The significance level adopted in the statistical analysis was 5%.
Results:
Median age was 63 years; 78.5% of the patients were receiving DAPT treatment for acute coronary syndrome. The rates of hospitalization for cardiovascular reasons, acute myocardial infartion, stent thrombosis and target-vessel revascularization were 7.9%, 2.3%, 1.3% and 4.2%, respectively. While the rate of BARC type 1 bleeding was 3.3%, the rate of BARC type 5, 3, or 2 bleeding was 0.6%. The secondary endpoints which were death from any cause, cardiovascular death and stroke were 0.5%, 0.3% and 0.3%, respectively. Conclusion: Our study shows that fixed-dose combination therapy is effective and safe in appropriately selected patients with acute or chronic coronary syndromes.
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