Efficacy and Safety of Dual Antiplatelet Therapy After Complex PCI

This study investigated the efficacy and safety of long-term ( ≥12 months) versus short-term (3 or 6 months) DAPT with aspirin and clopidogrel according to PCI complexity.MethodsThe authors pooled patient-level data from 6 randomized controlled trials investigating DAPT durations after PCI. Complex PCI was defined as having at least 1 of the following features: 3 vessels treated,  ≥3 stents implanted, ≥3 lesions treated, bifurcation with 2 stents implanted, total stent length>60 mm, or chronic total occlusion. The primary efficacy endpoint was major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction, or stent thrombosis. The primary safety endpoint was major bleeding. Intention-to-treat was the primary analytic approach.ResultsOf 9,577 patients included in the pooled dataset for whom procedural variables were available, 1,680 (17.5%) underwent complex PCI. Overall, 85% of patients received new-generation DES. At a median follow-up time of 392 days (interquartile range: 366 to 710 days), patients who underwent complex PCI had a higher risk of MACE (adjusted hazard  ratio [HR]: 1.98; 95% confidence interval [CI]: 1.50 to 2.60; p 

Source: Journal of the American College of Cardiology - October 18, 2016 Category: Cardiology Source Type: research