Dual antiplatelet therapy after PCI in patients at high bleeding risk
New England Journal of Medicine Sep 02, 2021
Valgimigli M, Frigoli E, Heg DH, et al. - This study’s findings demonstrate that one month of dual antiplatelet therapy was noninferior to the continuation of therapy for at least 2 additional months with regard to the occurrence of net adverse clinical events and major adverse cardiac or cerebral events; abbreviated therapy also resulted in a lower incidence of major or clinically relevant nonmajor bleeding.
The results reported net adverse clinical events in 165 patients (7.5%) in the abbreviated-therapy group and in 172 (7.7%) in the standard therapy group (difference, −0.23 percentage points; 95% confidence interval [CI], −1.80 to 1.33; P<0.001 for noninferiority) among the 4,434 patients in the per-protocol population.
A major adverse cardiac or cerebral event was reported in a total of 133 patients (6.1%) in the abbreviated therapy group and 132 patients (5.9%) in the standard therapy group (difference, 0.11 percentage points; 95% CI, −1.29 to 1.51; P=0.001 for noninferiority).
The results showed major or clinically relevant non-major bleeding in 148 patients (6.5%) in the abbreviated-therapy group and in 211 (9.4%) in the standard-therapy group among the 4,579 patients in the intention-to-treat population (difference, −2.82 percentage points; 95% CI, −4.40 to −1.24; P<0.001 for superiority).
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