Benefits and Risks of Extended Dual Antiplatelet Therapy After Everolimus-Eluting Stents

JACC. Cardiovascular Interventions
James HermillerDAPT Study Investigators

Abstract

The purpose of this study was to characterize outcomes for everolimus-eluting stent (EES)-treated subjects according to treatment with continued thienopyridine plus aspirin versus aspirin alone 12 to 30 months after stenting. In the DAPT (Dual Antiplatelet Therapy) study, continued thienopyridine plus aspirin beyond 1 year after coronary stenting reduced ischemic events. Given low rates of stent thrombosis and myocardial infarction (MI) for current drug-eluting stents, we examined outcomes among EES-treated subjects in the DAPT study. The DAPT study enrolled 25,682 subjects (11,308 EES-treated) after coronary stenting. Following 12 months of treatment with thienopyridine and aspirin, eligible subjects continued treatment with aspirin and 9,961 (4,703 with EES) were randomized to 18 months of continued thienopyridine or placebo. Stent type was not randomized, and the EES subset analysis was post hoc. Among EES-treated patients, continued thienopyridine reduced stent thrombosis (0.3% vs. 0.7%, hazard ratio [HR]: 0.38, 95% confidence interval [CI]: 0.15 to 0.97; p = 0.04) and MI (2.1% vs. 3.2%, HR: 0.63, 95% CI: 0.44 to 0.91; p = 0.01) versus placebo but did not reduce a composite of death, MI, and stroke (4.3% vs. 4.5%, HR: 0.89,...Continue Reading

Associated Clinical Trials

References

May 2, 2007·Circulation·Donald E CutlipUNKNOWN Academic Research Consortium
Jun 7, 2012·Circulation. Cardiovascular Interventions·Tullio PalmeriniGregg W Stone
Nov 18, 2014·The New England Journal of Medicine·Laura MauriUNKNOWN DAPT Study Investigators
Mar 18, 2015·JAMA : the Journal of the American Medical Association·Dean J KereiakesUNKNOWN Dual Antiplatelet Therapy (DAPT) Study Investigators
Oct 24, 2015·JACC. Cardiovascular Interventions·Dean J KereiakesUNKNOWN DAPT Study Investigators

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Citations

Jan 23, 2016·JACC. Cardiovascular Interventions·David R Holmes, Charanjit S Rihal
Jun 17, 2016·Expert Opinion on Pharmacotherapy·Yongwhi ParkDominick J Angiolillo
Mar 15, 2018·Journal of Cardiovascular Medicine·Simone Grotti, Leonardo Bolognese
Nov 7, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Byoung-Kwon LeeHyuck Moon Kwon
Oct 19, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Marco ValgimigliUNKNOWN ESC Scientific Document Group
Dec 14, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Bo XuGregg Stone
Jun 17, 2020·Expert Review of Medical Devices·Juan J Rodríguez-AriasSalvatore Brugaletta
Apr 13, 2018·Journal of Clinical Medicine·Surya ChaturvedulaAseem Vashist
Sep 18, 2020·Clinical Transplantation·Neeraj SinhaJoao Braghiroli
Aug 8, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Bo XuGregg W Stone
Jan 23, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Franz-Josef NeumannMichael O Zembala
Feb 23, 2019·Journal of Community Hospital Internal Medicine Perspectives·Mahmoud BarbarawiGhassan Bachuwa
Jun 22, 2019·Advances in Preventive Medicine·Muhammad Abdul Mabood KhalilJackson Tan
Aug 31, 2017·Drugs·Francesco CostaMarco Valgimigli
Aug 28, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Giuseppe GargiuloJohn A Bittl
Aug 31, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Miguel Sousa-UvaUNKNOWN ESC Scientific Document Group
Aug 31, 2018·European Heart Journal·Franz-Josef NeumannUNKNOWN ESC Scientific Document Group
Oct 28, 2017·Journal of the American College of Cardiology·Robert W YehUNKNOWN DAPT Study Investigators

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