Abbreviated Antiplatelet Therapy After Coronary Stenting in Patients With Myocardial Infarction at High Bleeding Risk

• DOI: 10.1016/j.jacc.2022.07.016
• Publication Date: 2022-09-19T21:16:08Z
• Authors: Pieter C. Smits; Enrico Frigoli; Pascal Vranckx; Yukio Ozaki; Marie-Claude Morice; Bernard Chevalier; Yoshinobu Onuma; Stephan Windecker; Pim A.L. Tonino; Marco Roffi; Maciej Lesiak; Felix Mahfoud; Jozef Bartunek; David Hildick-Smith; Antonio Colombo; Goran Stankovic; Andrés Iñiguez; Carl Schultz; Ran Kornowski; Paul J.L. Ong; Mirvat Alasnag; Alfredo E. Rodriguez; Valeria Paradies; Petr Kala; Sasko Kedev; Amar Al Mafragi; Willem Dewilde; Dik Heg; Marco Valgimigli
• Keywords: Polymers; percutaneous coronary intervention; Myocardial Infarction; Anticoagulants; 610 Medicine & health; Hemorrhage; dual antiplatelet therapy; antiplatelet therapy; acute coronary syndrome; 3. Good health; Percutaneous Coronary Intervention; Treatment Outcome; Dimaprit; acute coronary syndrome; antiplatelet therapy; dual antiplatelet therapy; percutaneous coronary intervention; Humans; Drug Therapy, Combination; Stents; Platelet Aggregation Inhibitors

The optimal duration of antiplatelet therapy (APT) after coronary stenting in patients at high bleeding risk (HBR) presenting with an acute syndrome remains unclear. objective this study was to investigate the safety and efficacy abbreviated APT regimen HBR population or recent myocardial infarction. In MASTER DAPT trial, 4,579 were randomized 1 month dual (DAPT) (DAPT stopped 11 months single 5 oral anticoagulants) nonabbreviated for minimum 3 months) strategies. Randomization stratified by infarction index procedure. Coprimary outcomes 335 days randomization net adverse clinical events (NACE); major cardiac cerebral (MACCE); type 2, 3, Bleeding Academic Research Consortium bleeding. NACE MACCE did not differ vs regimens (n = 1,780; HR: 0.83; 95% CI: 0.61-1.12 0.86; 0.62-1.19, respectively) without 2,799; 1.03; 0.77-1.38 1.13; 0.80-1.59; Pinteraction 0.31 0.25, respectively). significantly reduced (HR: 0.65; 0.46-0.91 0.71; 0.54-0.92; 0.72) APT. A 1-month strategy results similar rates reduces bleedings compared a strategy. (Management High Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With Abbreviated Versus Prolonged Regimen [MASTER DAPT]; NCT03023020)