P2Y12 Inhibitor Monotherapy vs. Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention – SMART-CHOICE. Presented at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans March 2019. This research compared safety and efficacy of short-duration dual antiplatelet therapy (3 months) compared with longer duration treatment (12 months) for people undergoing percutaneous coronary intervention (PCI). Subjects were randomly allocated to treatment for the shorter period (n = 1,495) or 12 months (n = 1,498): those allocated to the shorter pharmacotherapy intervention discontinued aspirin after 3 months but continued P2Y12 inhibitor monotherapy. The study also included stratification regarding the type of drug-eluting stent used. Those with active bleeding, previous drug-eluting stent implants within 12 months or a life expectancy of less than two years were excluded. The rate of major adverse cardiac and cerebrovascular events, all-cause death, MI, and stent thrombosis were not different, but bleeding was more common for those receiving dual treatment for longer. This finding should draw attention to the need for re-examination of current practices and further detailed research in the area.
Dual antiplatelets after percutaneous coronary intervention – longer treatment does not yield better outcomes
Mar 28, 2019