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Lookup NU author(s): Professor Vijay KunadianORCiD
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© 2024 Elsevier Inc.This analysis aimed to evaluate the effect of 1- versus 3-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in older patients. Data from 3 prospective, single-arm studies (XIENCE Short DAPT Program), including patients with high bleeding risk successfully treated with an everolimus-eluting stent (XIENCE, Abbott) were analyzed. DAPT was discontinued at 1 or at 3 months in patients free from ischemic events and adherent to DAPT. Patients were stratified according to age (≥75 and <75 years). The primary end point was all-cause death or myocardial infarction (MI). The key secondary end point was Bleeding Academic Research Consortium type 2 to 5 bleeding. The outcomes were assessed from 1 to 12 months after index PCI. Of 3,364 patients, 2,241 (66.6%) were aged ≥75 years. The risk of death or MI was similar with 1- versus 3-month DAPT in patients aged ≥75 (8.5% vs 8.0%, adjusted hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.69 to 1.30) and <75 years (6.9% vs 7.8%, adjusted HR 0.97, 95% CI 0.60 to 1.57, interaction p = 0.478). Bleeding Academic Research Consortium type 2 to 5 bleeding was consistently lower with 1- than with 3-month DAPT in patients aged ≥75 years (7.2% vs 9.4%, adjusted HR 0.66, 95% CI 0.48 to 0.91) and <75 years (9.7% vs 11.9%, adjusted HR 0.86, 95% CI 0.57 to 1.29, interaction p = 0.737). In conclusion, in patients at high bleeding risk who underwent PCI, patients older and younger than 75 years derived a consistent benefit from 1- compared with 3-month DAPT in terms of bleeding reduction, with no increase in all-cause death or MI at 1 year.
Author(s): Sardella G, Spirito A, Sartori S, Angiolillo DJ, Vranckx P, Hernandez JMDLT, Krucoff MW, Bangalore S, Bhatt DL, Campo G, Cao D, Chehab BM, Choi JW, Feng Y, Ge J, Godfrey K, Hermiller J, Kunadian V, Makkar RR, Maksoud A, Neumann F-J, Picon H, Saito S, Thiele H, Toelg R, Varenne O, Vogel B, Zhou Y, Valgimigli M, Windecker S, Mehran R
Publication type: Article
Publication status: Published
Journal: American Journal of Cardiology
Year: 2024
Volume: 214
Pages: 94-104
Print publication date: 01/03/2024
Online publication date: 06/01/2024
Acceptance date: 02/04/2018
ISSN (print): 0002-9149
ISSN (electronic): 1879-1913
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.amjcard.2023.12.049
DOI: 10.1016/j.amjcard.2023.12.049
PubMed id: 38185438
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