Comparing the effectiveness and safety of short-term versus long-term dual antiplatelet therapy after percutaneous coronary intervention in patients at high bleeding risk.

This study compared the effectiveness and safety of short-term versus long-term dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients at high bleeding risk. The data showed that short-term DAPT significantly reduced the risk of bleeding compared with long-term DAPT without an increase in the risk of death or heart attacks in these patients.

Coronary artery disease (CAD) is a condition in which the blood vessels in the heart become blocked. This reduces the blood flow to the heart. PCI (or angioplasty) is a non-surgical procedure where narrow or blocked arteries are widened or unblocked. In some cases, a stent is implanted. A stent is a flexible tube that keeps the artery open. Drug-eluting stents (DES) also release medication into the body. These drugs prevent cells from gathering inside the stent and blocking it again.

One risk with PCI using DES is that blood clots can form on the stent and cause a blockage. Platelets are cells in the blood involved in blood clotting. Dual antiplatelet therapy (DAPT) is used to reduce this risk. DAPT reduces the risk of clotting and further blockages after PCI. Acetylsalicylic acid (Aspirin) and ticagrelor (Brilique) are antiplatelet medications commonly used in DAPT.

DAPT for at least 6-12 months is commonly prescribed after PCI with DES. However, DAPT increases the risk of bleeding in patients with CAD. It is not known how a short-term DAPT prescription compares to long-term DAPT after PCI using DES in patients at high bleeding risk.

This study analyzed 9 other studies and involved a total of 16848 patients undergoing PCI using DES at high bleeding risk. Patients were divided into 2 groups. Group 1 included patients who received long-term DAPT for 6-12 months after PCI. Group 2 included patients who received short-term DAPT for less than 3 months after PCI.

2.6% of patients in group 2 reported major bleeding events compared to 3.8% of patients in group 1. Short-term DAPT reduced the risk of major bleeding by 32% compared to long-term DAPT.

There was no significant difference in heart attacks, stroke rates, death events, or stent blockage rates between the 2 groups.

This study concluded that short-term DAPT significantly reduced the risk of bleeding compared with long-term DAPT without increased risks of death or heart attacks in patients undergoing PCI with DES at high bleeding risk.

The studies analyzed had different study designs, different criteria for including patients at high bleeding risk, and different antiplatelet agents used.