P2Y12 inhibitor monotherapy scores over continued DAPT after complex PCI: JACC
Italy: Dropping aspirin after 1-3 months of DAPT (dual antiplatelet therapy) among patients undergoing PCI is associated with no increase in ischemic and fatal events and less bleeding versus continuing standard DAPT, regardless of procedural complexity, according to a meta-analysis of randomized trials.
"P2Y12 inhibitor monotherapy after 1-3 months of DAPT was linked with comparable rates of ischemic and fatal events and lower bleeding risk compared with standard DAPT, irrespective of PCI complexity," Felice Gragnano from the University of Campania Luigi Vanvitelli in Caserta, Italy, and colleagues wrote in their study that featured in Journal of the American College of Cardiology.
The study was conducted given the unclarity of whether P2Y12 inhibitor monotherapy protects against ischemic events while limiting the risk of major bleeding compared with DAPT after complex PCI (percutaneous coronary intervention). The research team aimed to examine the effects of P2Y12 inhibitor monotherapy after 1 to 3-month DAPT compared to standard DAPT regarding PCI complexity.
For this purpose, the researchers pooled patient-level data from randomized controlled trials drawing a comparison between P2Y12 inhibitor monotherapy and standard DAPT on outcomes following revascularization. Complex PCI was defined as any of six criteria: ≥3 stents implanted, three vessels treated, bifurcation with two stents implanted, ≥ three lesions treated, chronic total occlusion, or total stent length >60 mm.
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