Abbreviated vs. Standard DAPT Therapy After PCI

In patients at high risk for bleeding, use of an abbreviated antiplatelet regimen reduced bleeding without increasing major adverse ischemic events.

A large, randomized trial compared antiplatelet therapy approaches in patients at high bleeding risk after percutaneous coronary intervention (PCI) with a biodegradable-polymer drug-eluting stent (NEJM JW Cardiol Sep 1 2021; [e-pub]). Initial results at 12 months demonstrated no difference in adverse cardiovascular events and less bleeding in patients receiving abbreviated dual antiplatelet therapy (DAPT) — i.e., switching to single antiplatelet therapy after 1 month — than in those receiving a standard DAPT regimen — i.e., receiving at least 3–6 months of DAPT. Investigators now report final 15-month results.

Routine care at physician discretion was allowed at 1 year. At 15 months, follow-up was >99% complete, most patients in both groups w…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)