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1- Versus 3-month DAPT in older patients at a high bleeding risk undergoing PCI: insights from the XIENCE short DAPT global program

Abstract: 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.

 Fuente: American Journal of Cardiology, 2024, 214, 94-104

 Editorial: Elsevier

 Año de publicación: 2024

 Nº de páginas: 11

 Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.amjcard.2023.12.049

 ISSN: 0002-9149,1879-1913

 Url de la publicación: https://doi.org/10.1016/j.amjcard.2023.12.049

Autoría

SARDELLA, GENNARO

SPIRITO, ALESSANDRO

SARTORI, SAMANTHA

ANGIOLILLO, DOMINICK J.

KRUCOFF, MTICHELL W.

BANGALORE, SRIPAL

BHATT, DEEPAK L.

CAMPO, GIANLUCA

CAO, DAVIDE

CHEHAB, BASSEM

CHOI, JAMES W.

FENG, YIHAN

GE, JUNBO

GODFREY, KATHERINE

HERMILLER, JAMES

KUNADIAN, VIJAY

MAKKAR, RAJ R.

MAKSOUD, AZIZ