In a Chinese trial, patients with multivessel coronary artery disease who were in stable condition on DAPT in the 12 months after PCI were randomized to extended DAPT or aspirin monotherapy.Extending DAPT with clopidogrel and aspirin for an additional 12 months led to a lower risk of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke than continuing aspirin alone, without an increased risk of bleeding.Results suggest that the standard 12-month DAPT regimen after PCI in multivessel disease and acute coronary syndrome may not suffice.
There was strong evidence for extending dual antiplatelet therapy (DAPT) beyond the standard 12 months in selected patients with multivessel coronary artery disease (CAD), the DAPT-MVD trial found.
These were nonelderly patients who'd undergone coronary stenting, for an acute coronary syndrome (ACS) in virtually all cases, and were finishing a 12-month course of DAPT without having experienced major ischemic or bleeding complications, demonstrating low bleeding risk.
In these patients, having DAPT extended another 12 months (followed by aspirin thereafter) resulted in a lower incidence of death from cardiovascular causes, nonfatal myocardial infarction, and nonfatal stroke at 36 months compared with aspirin monotherapy (5.8% vs 6.8%, HR 0.82, 95% CI 0.69-0.98), according to Bo Yu, MD, of Second Affiliated Hospital of Harbin Medical University in China, and colleagues.
