Efficacy and Safety of Dual Antiplatelet Therapy in High-Risk, Post-Percutaneous Coronary Intervention Patients beyond One Year  

作　　者：Avinash Singh Rupesh Sinha Mahim Saran Danish Kazmi Himanshu Gupta Ganesh Seth Avinash Singh;Rupesh Sinha;Mahim Saran;Danish Kazmi;Himanshu Gupta;Ganesh Seth(Medanta Super Specialty Hospital, Lucknow, India;L.P.S Institute of Cardiology Kanpur, Kanpur, India)

机构地区：[1]Medanta Super Specialty Hospital, Lucknow, India [2]L.P.S Institute of Cardiology Kanpur, Kanpur, India

出　　处：《World Journal of Cardiovascular Diseases》2025年第2期117-126,共10页心血管病(英文)

摘　　要：Background: Individuals with coronary artery disease (CAD) who have undergone a percutaneous coronary intervention (PCI) are at an increased risk for adverse coronary events. Management with dual antiplatelet therapy (DAPT) has been indicated in this group, however, DAPT significantly increases the risk of bleeding. Objectives: This study aimed to evaluate aspirin versus clopidogrel and aspirin on major adverse cardiac and cerebrovascular events (MACCE) and risk of bleeding in individuals already on DAPT for one year after undergoing PCI. Methods: This was a single-center, double-arm, interventional, prospective study. A total of 956 individuals who had undergone PCI and were on DAPT for a year were enrolled. After calculating DAPT scores, individuals with DAPT scores ≥2 were assigned to the aspirin and clopidogrel group, and those with DAPT scores Results: The group on clopidogrel and aspirin demonstrated a significantly lower rate of MACCE when compared to those on aspirin alone (p = 0.003). However, stent thrombosis, stroke, and myocardial infarction (MI) did not significantly differ in an inter-group comparison. The rate of moderate bleeding was greater in the clopidogrel group;however, the difference was not found to be statistically significant (p = 0.19). Conclusions: Continuing DAPT for a period between 12 and 24 months after PCI in individuals with a DAPT score ≥2 had favorable outcomes in reducing coronary adverse events without resulting in significant bleeding.Background: Individuals with coronary artery disease (CAD) who have undergone a percutaneous coronary intervention (PCI) are at an increased risk for adverse coronary events. Management with dual antiplatelet therapy (DAPT) has been indicated in this group, however, DAPT significantly increases the risk of bleeding. Objectives: This study aimed to evaluate aspirin versus clopidogrel and aspirin on major adverse cardiac and cerebrovascular events (MACCE) and risk of bleeding in individuals already on DAPT for one year after undergoing PCI. Methods: This was a single-center, double-arm, interventional, prospective study. A total of 956 individuals who had undergone PCI and were on DAPT for a year were enrolled. After calculating DAPT scores, individuals with DAPT scores ≥2 were assigned to the aspirin and clopidogrel group, and those with DAPT scores Results: The group on clopidogrel and aspirin demonstrated a significantly lower rate of MACCE when compared to those on aspirin alone (p = 0.003). However, stent thrombosis, stroke, and myocardial infarction (MI) did not significantly differ in an inter-group comparison. The rate of moderate bleeding was greater in the clopidogrel group;however, the difference was not found to be statistically significant (p = 0.19). Conclusions: Continuing DAPT for a period between 12 and 24 months after PCI in individuals with a DAPT score ≥2 had favorable outcomes in reducing coronary adverse events without resulting in significant bleeding.

关 键 词：ASPIRIN Clopidogrel Drug-Eluting Stents Dual Antiplatelet Therapy Percutaneous Coronary Intervention 

分 类 号：R54[医药卫生—心血管疾病]