Kopin D, et al. - This study entails the evaluation of antiplatelet therapy use and outcomes in patients undergoing PCI during the ARISTOTLE trial. Follow up revealed infrequent occurrence of PCI. Additionally, it was noted that the majority of patients on study drug at the time of PCI remained on study drug in the peri-PCI period; 19% continued the study drug without interruption. A variance was observed in the antiplatelet therapy use post-PCI, though dual antiplatelet therapy (DAPT) was given to the majority of patients. There is a need for additional data in order to guide the use of antithrombotics in patients undergoing PCI.

Methods

• Researchers grouped patients based on the occurrence of PCI during follow-up (median 1.8 years); PCI details and outcomes post-PCI are reported.
• A total of 18,201 subjects were included, of those, 316 (1.7%) underwent PCI (152 in apixaban group, 164 in warfarin group).

Results

• Data showed that 84% (267) were on study drug (either apixaban or warfarin) at the time of PCI, of these, 19% did not stop study drug during PCI, 49% stopped and restarted <5 days post-PCI, and 30% stopped and restarted >5 days post-PCI.
• Researchers found that at 30 days post-PCI, 35% of patients received dual antiplatelet therapy (DAPT), 23% received aspirin only, and 13% received a P2Y₁₂ inhibitor only; 29% received no antiplatelet therapy.
• Furthermore, it was noted that 21% patients received triple therapy (DAPT + oral anticoagulant [OAC]), 23% received OAC only, 15% received OAC plus aspirin, and 9% received OAC plus a P2Y₁₂ inhibitor; 32% received antiplatelet agents without OAC.
• Results revealed that following PCI, patients assigned to apixaban vs warfarin had numerically similar rates of major bleeding (5.93 vs 6.73 events/100 patient-years; p=0.95) and stroke (2.74 vs 1.84 events/100 patient-years; p=0.62).