Effect of dual antiplatelet therapy prolongation in acute coronary syndrome patients with both high ischemic and bleeding risk: insight from the OPT-CAD study

• DOI: 10.3389/fcvm.2023.1201091
• Publication Date: 2023-09-08T09:06:31Z
• Authors: Kun Na; Miaohan Qiu; Ningxin Wei; Jiayin Li; Chenghui Yan; Jing Li; Yi Li; Yaling Han
• Keywords: Discontinuation

In current clinical practice, controversy remains regarding the benefits of prolonged dual antiplatelet therapy (DAPT) in acute coronary syndrome (ACS) patients facing high risks both ischemia and bleeding ("bi-risk") following percutaneous intervention (PCI). This study aimed to investigate feasibility identifying a group bi-risk ACS after PCI using OPT-BIRISK criteria, emphasizing extended DAPT treatment safety efficacy beyond 12 months these real-world conditions.This analysis compared single (SAPT) at 12-24 undergoing complicated with ischemic risk as defined by criteria without premature discontinuation before 9 or major adverse events within months. was post hoc Optimal antiPlatelet Antiplatelet Therapy for Chinese Patients Coronary Artery Disease (OPT-CAD) study. The main research outcome incidence months, which determined composite stroke, myocardial infarction, cardiac death events. Through propensity score matching (PSM), groups were balanced. For external validation identify patient, events, BARC 2, 3, 5 years analyzed.The total number analyzed this 7,049, whom 4,146 (58.8%) 2,903 (41.2%) not. frequency significantly different between two (11.70% vs. 5.55%, P < 0.001), 2,3,5 higher (6.90% 4.03%, 0.001) than non-bi-risk group. Among any that underwent (n = 2,374, 75.7%) exhibited lower stroke (1.10% 2.10%, 0.036) relative those SAPT 763, 24.3%), while did not differ groups. PSM cohort results consistent overall analyses.In conclusion, findings showed could help physicians developing recurrent episodes PCI. Compared monotherapy, strategy may offer potential lowering carrying disproportionately serious problems among who event-free year DAPT.