The Effect of Dual Antiplatelet Therapy Duration on PCI Outcomes in Diabetics With a History of GI Bleed

To evaluate the effect of dual antiplatelet therapy (DAPT) duration on the outcomes of percutaneous coronary intervention (PCI) in diabetic patients with a history of gastrointestinal (GI) bleeding. This study included 5321 diabetic patients who underwent PCI and were categorized into two groups based on the duration of DAPT: short-term (≤ 6 months) and long-term (> 6 months). Data on patient demographics, comorbidities, PCI indications, and treatment outcomes were collected. The primary outcomes included major adverse cardiovascular events (MACE), recurrent GI bleeding, and all-cause mortality. Predictors of noncompliance with DAPT were also analyzed. There was no significant difference in the rates of MACE, myocardial infarction, stroke, cardiovascular death, recurrent GI bleeding, or all-cause mortality between the short-term and long-term DAPT groups. However, noncompliance with DAPT was more common in older patients, males, those with longer diabetes duration, renal dysfunction, smoking history, polypharmacy, and those with acute coronary syndrome. DAPT duration did not significantly impact major clinical outcomes in diabetic patients with a history of GI bleeding undergoing PCI. Noncompliance with DAPT was influenced by patient-specific factors, highlighting the importance of personalized treatment strategies and improving adherence to therapy. Further studies are needed to refine guidelines for DAPT duration in this high-risk population.