The Particulars: Dual antiplatelet therapy (DAPT) is recommended for the prevention of thrombotic complications following coronary stenting. However, little is known about the benefits and risks of DAPT beyond 1 year.

Data Breakdown: For a study, patients who had received a drug-eluting stent were administered 12 months of DAPT with a thienopyridine drug and aspirin. Participants were then randomized to continue this treatment or receive a placebo and aspirin for another 18 months. The researchers observed the following:

 

Outcome DAPT Treatment Group Aspirin Therapy Treatment Group
Stent thrombosis 0.4% 1.4%
Major adverse cardiovascular and cerebrovascular events 4.3% 5.9%
Myocardial infarction 2.1% 4.1%
All-cause mortality 2.0% 1.5%
Moderate or severe bleeding 2.5% 1.6%

 

Take Home Pearls: Following placement of a drug-eluting stent, DAPT beyond 1 year appears to significantly reduce the risks of stent thrombosis and major cardiovascular and cerebrovascular events when compared with aspirin therapy alone. However, DAPT appears to be associated with an increased risk of bleeding.