- A short, one-month treatment combining antiplatelet medication and aspirin followed by an aspirin-only regime was as effective as a 6- to 12-month course of dual treatment at preventing death, heart attacks, strokes, bleeding or the need for additional stent placement.
- The results of this study could lead to changes in treatment and improve patient compliance, lower costs and fewer side effects.
Embargoed until 7:50 p.m. CT/8:50 p.m. ET, Sunday, Nov. 15, 2020
DALLAS, Nov. 15, 2020 — A one-month treatment of dual anti-platelet therapy is safe and as effective as a longer duration of therapy at preventing cardiac events in patients one year after stent placement, according to late-breaking research presented today at the American Heart Association’s Scientific Sessions 2020. The virtual meeting is Friday, November 13-Tuesday, November 17, 2020, and is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science for health care worldwide.
“This study is the first randomized trial comparing one-year clinical outcomes of one-month of dual anti-platelet therapy followed by aspirin monotherapy to the currently recommended dual anti-platelet therapy regimen in patients with coronary artery disease who are recovering from stent placement,” said lead study investigator Myeong-Ki Hong, M.D., Ph.D., professor of cardiology at Yonsei University College of Medicine, Severance Cardiovascular Hospital in Seoul, Korea.
Patients recovering from artery-opening procedures involving a stent are prescribed one or more anti-platelet medications (to help keep platelets from sticking together), typically for months, along with aspirin to prevent blood from clotting in the stent. This is known as dual anti-platelet therapy. Dual anti-platelet therapy, also known as DAPT, can pose a significant risk of bleeding for patients who are already taking blood thinners.
Most studies evaluating a shorter course of DAPT have focused on patients at high-risk for bleeding. Additionally, many recent studies have also focused on patients receiving a class of antiplatelet known as a P2Y12 inhibitor monotherapy rather than aspirin monotherapy after a shorter course of DAPT.
Researchers in this study evaluated and compared the safety and effectiveness of two durations of dual anti-platelet therapy in patients who had drug-eluting stent placement or polymer-free drug-coated stent placement and were not at a high-risk of bleeding.
Across 23 medical centers in Korea, 3,020 Korean patients (mean age 67; 31% women) were randomly assigned to receive either:
- one-month of dual anti-platelet therapy after polymer-free drug-coated stent placement followed by 11 months of aspirin alone;
- or 6-12 months duration of anti-platelet therapy followed by 0-6 months of aspirin alone after drug-eluting stent placement procedure.
Drug-eluting stents are coated with a polymer that slowly releases medication designed to reduce the risk of the artery reclogging. Polymer-free drug-coated stents are a newer type of stent created to address potential inflammation caused by polymer.
Most of the patients (2,969) completed a one-year follow-up. Analysis found there was no significant difference in the number of cardiac events between the two groups: 5.9% of patients in the one-month treatment group died or had a heart attack, stroke, major bleeding or stent/ angioplasty procedure, compared to 6.5% in the 6- to 12-month treatment group.
“It is encouraging to see that one-month dual anti-platelet therapy, followed by aspirin monotherapy after polymer-free drug-coated stent is effective and safe in a diverse group of patients with coronary artery disease,” Hong said. “These results also could lead to the suggestion for some patients to discontinue a P2Y12 inhibitor, rather than aspirin, in daily clinical practice, which could result in better patient compliance, lower costs, a lower risk of bleeding, and overall, more convenience for both patients and physicians.”
Co-authors are Sung-jin Hong, M.D.; Jung-sun Kim, M.D.; Soon Jun Hong, M.D.; Kyeong Ho Yun, M.D.; Jong kwan Park, M.D.; Chul-min Ahn, M.D.; Byeong-Keuk Kim, M.D.; Young-Guk Ko, M.D.; Donghoon Choi, M.D.; and Yangsoo Jang . Author disclosures are in the abstract.
This study is funded by DIO (Korea), Cardinal Health Korea (Korea) and Terumo Corporation (Tokyo, Japan).
Note: Session: LBS 05: Stents, Valves and Clots.
- Multimedia is available on the right column of the release link https://newsroom.heart.org/news/one-month-of-dual-anti-platelet-therapy-is-safe-and-feasible-after-stent-placement?preview=eda5aeac209dffe37bb5f809a523cd4d
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- For more news at AHA Scientific Sessions 2020, follow us on Twitter @HeartNews
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