Just 1 month of DAPT after PCI shows promise, new meta-analysis confirms

One month of dual antiplatelet therapy (DAPT) followed by standard antiplatelet therapy (SAPT) may be a safe and effective treatment option for patients after percutaneous intervention (PCI), according to new data published in the American Journal of Cardiology.

Researchers noted that recent advancements in stent technology have contributed to a reduction in the duration of DAPT, which often lasts six months or even one full year.

"The optimal duration of DAPT after PCI is still debated," wrote lead author Mohamed M.G. Mohamed, MD, MPH, with the internal medicine department at SSM Health St. Mary’s Hospital in St. Louis, and colleagues. "Current American and European guidelines recommend at least 6 months of DAPT after drug-eluting stent placement in stable coronary artery disease, and at least 12 months after acute coronary syndrome."

The group examined data from four different studies, totally more than 26,000 patients. While 13,282 patients were prescribed DAPT for one month, the remaining 13,294 patients were prescribed standard (longer) DAPT. Twenty-five percent of patients were women, and the mean patient age was 67.2 years old.

Looking closer at participants from the four studies, the researchers noted that 71.4% of patients presented with hypertension, 29.6% had diabetes, 45.5% had acute coronary syndrome, 31% had previous PCI and 5% had prior coronary artery bypass graft. One study involved only patients with a high bleeding risk.

In the analysis, there were no differences between groups regarding all-cause mortality, nonfatal MI, stroke stent thrombosis, target vessel revascularization or major bleeding.

Also, one-month DAPT followed by SAPT showed "no statistical difference" compared to standard DAPT greater than three months when it came to all-cause mortality, nonfatal MI, stroke, stent thrombosis, target vessel revascularization or and major bleeding in patients with or without a high bleeding risk.

“Further RCTs powered to evaluate long-term outcomes are needed,” the authors added. 

Read the full study here.

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