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One-month of dual anti-platelet therapy is safe and feasible after stent placement

Research Highlights:

  • A short, one-month treatment combining antiplatelet medication and aspirin followed by an aspirin-only regime was as effective as a 6- to 12-month course of dual treatment at preventing death, heart attacks, strokes, bleeding or the need for additional stent placement.
  • The results of this study could lead to changes in treatment and improve patient compliance, lower costs and fewer side effects.

Embargoed until 7:50 p.m. CT/8:50 p.m. ET, Sunday, Nov. 15, 2020

(NewMediaWire) – November 15, 2020 – DALLAS – A one-month treatment of dual anti-platelet therapy is safe and as effective as a longer duration of therapy at preventing cardiac events in patients one year after stent placement, according to late-breaking research presented today at the American Heart Association’s Scientific Sessions 2020. The virtual meeting is Friday, November 13-Tuesday, November 17, 2020, and is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science for health care worldwide.

“This study is the first randomized trial comparing one-year clinical outcomes of one-month of dual anti-platelet therapy followed by aspirin monotherapy to the currently recommended dual anti-platelet therapy regimen in patients with coronary artery disease who are recovering from stent placement,” said lead study investigator Myeong-Ki Hong, M.D., Ph.D., professor of cardiology at Yonsei University College of Medicine, Severance Cardiovascular Hospital in Seoul, Korea.

Patients recovering from artery-opening procedures involving a stent are prescribed one or more anti-platelet medications (to help keep platelets from sticking together), typically for months, along with aspirin to prevent blood from clotting in the stent. This is known as dual anti-platelet therapy. Dual anti-platelet therapy, also known as DAPT, can pose a significant risk of bleeding for patients who are already taking blood thinners.

Most studies evaluating a shorter course of DAPT have focused on patients at high-risk for bleeding. Additionally, many recent studies have also focused on patients receiving a class of antiplatelet known as a P2Y12 inhibitor monotherapy rather than aspirin monotherapy after a shorter course of DAPT.

Researchers in this study evaluated and compared the safety and effectiveness of two durations of dual anti-platelet therapy in patients who had drug-eluting stent placement or polymer-free drug-coated stent placement and were not at a high-risk of bleeding.

Across 23 medical centers in Korea, 3,020 Korean patients (mean age 67; 31% women) were randomly assigned to receive either:

  • one-month of dual anti-platelet therapy after polymer-free drug-coated stent placement followed by 11 months of aspirin alone;
  • or 6-12 months duration of anti-platelet therapy followed by 0-6 months of aspirin alone after drug-eluting stent placement procedure.

Drug-eluting stents are coated with a polymer that slowly releases medication designed to reduce the risk of the artery reclogging. Polymer-free drug-coated stents are a newer type of stent created to address potential inflammation caused by polymer.

Most of the patients (2,969) completed a one-year follow-up. Analysis found there was no significant difference in the number of cardiac events between the two groups: 5.9% of patients in the one-month treatment group died or had a heart attack, stroke, major bleeding or stent/ angioplasty procedure, compared to 6.5% in the 6- to 12-month treatment group.

“It is encouraging to see that one-month dual anti-platelet therapy, followed by aspirin monotherapy after polymer-free drug-coated stent is effective and safe in a diverse group of patients with coronary artery disease,” Hong said. “These results also could lead to the suggestion for some patients to discontinue a P2Y12 inhibitor, rather than aspirin, in daily clinical practice, which could result in better patient compliance, lower costs, a lower risk of bleeding, and overall, more convenience for both patients and physicians.”

Co-authors are Sung-jin Hong, M.D.; Jung-sun Kim, M.D.; Soon Jun Hong, M.D.; Kyeong Ho Yun, M.D.; Jong kwan Park, M.D.; Chul-min Ahn, M.D.; Byeong-Keuk Kim, M.D.; Young-Guk Ko, M.D.; Donghoon Choi, M.D.; and Yangsoo Jang . Author disclosures are in the abstract.

This study is funded by DIO (Korea), Cardinal Health Korea (Korea) and Terumo Corporation (Tokyo, Japan).

Note: Session: LBS 05: Stents, Valves and Clots

Additional Resources:

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers are available here, and the Association’s overall financial information is available here

About the American Heart Association

The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

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For Media Inquiries and AHA Expert Perspective:

AHA News Media in Dallas: 214-706-1173; ahacommunications@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

 

 



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