No advantage to prolonging DACT after bare-metal stent implantation

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 Takeaway

  • Short dual antiplatelet therapy (DAPT) after bare-metal stent (BMS) implantation appears to be as safe as prolonged DAPT in both patients with and patients without acute myocardial infarction (AMI).

Study design

  • Randomized controlled comparison of short vs prolonged DAPT on clinical outcomes at 2 mo among CREDO-Kyoto registry cohort-2.
  • Study population comprised 4905 patients: 2575 with single antiplatelet therapy (SAPT), 2330 with DAPT.
  • Therapy: aspirin (≥81 mg/d) indefinitely, thienopyridine (200 mg ticlopidine or 75 mg clopidogrel/d) for ≥1 mo. after BMS implantation.
  • Persistent discontinuation: withdrawal lasting ≥2 mo.
  • Primary outcome: composite of cardiovascular death, MI, stroke, definite stent thrombosis, global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries, cardiovascular bleeding.
  • Secondary outcome: ischemic, bleeding endpoints.
  • Stratified analysis based on clinical presentation at index percutaneous coronary intervention, based on AMI/non-AMI.
  • Funding: Study funded by Pharmaceuticals and Medical Devices Agency.

Key results

  • No significant difference observed in cumulative, 3-y incidence of primary outcome between SAPT, DAPT groups (9.8...