Short-term anti-platelet therapy: can it prevent cardiovascular events after percutaneous coronary intervention (PCI)?

This study investigated if short-term dual antiplatelet therapy (DAPT) improves outcomes after percutaneous coronary intervention (PCI).

They found that short-term DAPT did not increase the risk of heart attacks or clots after PCI.

Patients with coronary artery disease (CAD) may have blockages in the arteries supplying blood to the heart. Percutaneous coronary intervention (PCI) is a surgical technique that restores blood flow by removing a blockage. After PCI patients will take medications to prevent blood clots. This is called dual antiplatelet therapy (DAPT). DAPT is a combination of aspirin and a drug that blocks the P2Y12 receptor, such as clopidogrel (Plavix).

DAPT is prescribed for 3-6 months in patients that are considered low-risk. Patients who had an acute coronary syndrome (ACS) are considered high-risk. Some studies suggest that patients with ACS should take DAPT for up to 12 months following PCI. It is unclear if the risk of heart attack or blood clots is greater in patients on short- or long-term DAPT after PCI.

This study included 10 clinical trial reports with a total of 12,696 patients. The patients in these studies were considered high risk (ACS). Short-term DAPT ranged from 3-6 months. Long-term DAPT ranged from 12-24 months. The authors analyzed the rates of myocardial infarction (heart attack) and stent thrombosis (blood clots).

The risk of heart attack was similar in patients on short- and long-term DAPT. The risk of blood clots was also similar in short- and long-term DAPT patients. There was no difference in the rates of cardiac death or all-cause death between the two groups. 

The authors concluded that short-term DAPT did not increase the risk of heart attacks or clots after PCI.

There was a trend for increased risk of clotting in short-term DAPT patients. This was not statistically significant, however, the authors caution the use of short-term DAPT in patients with ACS until further investigation is performed. 

If you have any concerns regarding CAD treatment, please discuss this with your doctor.