Dual antiplatelet therapy duration after the placement of a drug-eluting stent: what are the data?

Current Treatment Options in Cardiovascular Medicine
Jad Raffoul, Andrew J P Klein

Abstract

The data supporting the immediate use of dual antiplatelet therapy (DAPT) post implantation of drug-eluting stents (DESs) is irrefutable. DAPT in this early period is necessary to prevent stent thrombosis during endothelialization of the stent, a process known to be delayed when DESs are placed. In addition, DAPT helps prevent thrombosis from plaque rupture that occurs outside of the initial stented area and/or at neo-atherosclerotic lesions within a previously coated stent. The ACC/AHA current guidelines (Levine et al. J Am Coll Cardiol. 58(24):e44-122, 2011) recommend 12 months of DAPT post DES implantation. As the result of several randomized clinical trials (Task Force on Myocardial Revascularization of the European Society of Cardio-Thoracic Surgery (EACTS) et al. Eur Heart J. 31(20):2501-55, 2010) showing the safety of a shorter duration of DAPT, the European Heart Society altered their recommendations to 6-12 months of DAPT post DES implantation. However, recent data from the DAPT trial (Mauri et al. N Engl J Med. 371(23):2156-66, 2014) clearly demonstrated less ischemic events with 30 months of DAPT. This trial and others have established that an increased DAPT duration increases bleeding risk which, in turn, increases ...Continue Reading

References

Feb 1, 1994·Journal of the American College of Cardiology·Y UedaK Kodama
Aug 25, 2001·The New England Journal of Medicine·S YusufUNKNOWN Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators
Aug 25, 2001·Lancet·S R MehtaUNKNOWN Clopidogrel in Unstable angina to prevent Recurrent Events trial (CURE) Investigators
Nov 13, 2002·Journal of the American College of Cardiology·James L OrfordPeter B Berger
May 5, 2005·JAMA : the Journal of the American Medical Association·Ioannis IakovouAntonio Colombo
Sep 7, 2005·JAMA : the Journal of the American Medical Association·Marc S SabatineUNKNOWN Clopidogrel as Adjunctive Reperfusion Therapy (CLARITY)-Thrombolysis in Myocardial Infarction (TIMI) 28 Investigators
Nov 8, 2005·Lancet·Z M ChenUNKNOWN COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group
May 16, 2006·Journal of the American College of Cardiology·Jun-ichi KotaniSeiki Nagata
Jul 4, 2006·Journal of the American College of Cardiology·Michael JonerRenu Virmani
Jul 25, 2006·The American Journal of Cardiology·Duk-Woo ParkSeung-Jung Park
Dec 7, 2006·JAMA : the Journal of the American Medical Association·Eric L EisensteinRobert M Califf
Dec 19, 2006·Journal of the American College of Cardiology·Matthias PfistererUNKNOWN BASKET-LATE Investigators
Nov 6, 2007·The New England Journal of Medicine·Stephen D WiviottUNKNOWN TRITON-TIMI 38 Investigators
Jan 26, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Yo IwataIssei Komuro
Apr 18, 2009·Journal of the American College of Cardiology·Jochem W van WerkumJurriën M ten Berg
Sep 1, 2009·The New England Journal of Medicine·Lars WallentinMona Thorsén
Mar 17, 2010·The New England Journal of Medicine·Seung-Jung ParkKeun Lee
May 7, 2010·The New England Journal of Medicine·Richard A Lange, L David Hillis
May 19, 2011·Circulation. Cardiovascular Quality and Outcomes·Urania Dafni
Mar 23, 2012·Circulation·Marco ValgimigliUNKNOWN Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia Study (PRODIGY) Investigators
Sep 22, 2012·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Elvin KedhiPieter C Smits
Dec 25, 2012·Current Treatment Options in Cardiovascular Medicine·Benjamin Z Galper, Laura Mauri
Jan 15, 2013·European Heart Journal·Marco ValgimigliUNKNOWN PROlonging Dual antiplatelet treatment after Grading stent-induced Intimal hyperplasia studY Investigators
Sep 23, 2014·Journal of the American College of Cardiology·David R Holmes
Nov 18, 2014·The New England Journal of Medicine·Antonio Colombo, Alaide Chieffo
Nov 18, 2014·The New England Journal of Medicine·Laura MauriUNKNOWN DAPT Study Investigators

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