Patients treated with long-duration anti-platelet therapies after the placement of a drug-eluting stent showed lower rates of heart attack but higher rates of major bleeding events and a slight increase in mortality, according to a new study released today.
Researchers analyzed 9 studies of randomized-controlled trials to compare the outcomes of shorter and longer duration DAPT therapies following drug eluting stent placements in over 28,000 coronary artery disease patients for the report, published in the Annals of Internal Medicine.
Lead author Dr. Gordon Guyatt of Ontario, Canada’s McMaster University told MassDevice.com that although the study found very small effects, they could be important to certain people.
Patients treated with short-term DAPT after stent placement had an 0.8% higher risk of heart attacks, Guyatt told us. In patients treated with longer-term DAPT, 0.6% would have major gastrointestinal bleeding, and 0.2% would die, he said.
"The difference between taking [DAPT] and not taking it long-term is under 1%, but there are some trade offs," Dr. Guyatt said. "The recommendations are in favor – clearly in favor – of the extended duration of dual-antiplatelet therapy. These results suggest that that should be reconsidered."
Data from the study indicates that patients and providers should take into consideration current conditions and the possible consequences of extended DAPT, said Dr. Guyatt, calling the choice a "value decision."