November 15, 2020
Korean Study Supports Safety and Feasibility of 1-Month DAPT After Stent Placement
November 15, 2020—A 1-month treatment of dual antiplatelet therapy (DAPT) is safe and as effective as a longer duration of therapy at preventing cardiac events in patients 1 year after stent placement, according to a study led by Myeong-Ki Hong, MD, professor of cardiology at Yonsei University College of Medicine, Severance Cardiovascular Hospital in Seoul, Korea.
“This study is the first randomized trial comparing 1-year clinical outcomes of 1-month of DAPT followed by aspirin monotherapy to the currently recommended DAPT regimen in patients with coronary artery disease who are recovering from stent placement,” commented lead study investigator Dr. Hong in an announcement from the American Heart Association (AHA).
The findings were presented in a late-breaking session at the AHA’s Scientific Sessions 2020 held as a virtual meeting on November 13-17.
According to the AHA, the study investigators evaluated and compared the safety and effectiveness of two durations of DAPT in patients who had drug-eluting stent placement or polymer-free drug-coated stent placement and were not at a high risk of bleeding.
The study enrolled 3,020 patients (mean age 67; 31% women) at 23 medical centers in Korea who were randomly assigned to receive either:
- 1 month of DAPT after polymer-free drug-coated stent placement followed by 11 months of aspirin alone; or
- 6 to 12 months duration of DAPT followed by 0 to 6 months of aspirin alone after drug-eluting stent placement procedure
Most of the patients (2,969) completed a 1-year follow-up. Analysis found there was no significant difference in the number of cardiac events between the two groups: 5.9% of patients in the 1-month treatment group died or had a heart attack, stroke, major bleeding, or stent/angioplasty procedure compared to 6.5% in the 6- to 12-month treatment group.
“It is encouraging to see that 1-month DAPT, followed by aspirin monotherapy after polymer-free drug-coated stent is effective and safe in a diverse group of patients with coronary artery disease,” commented Dr. Hong in the AHA announcement. “These results also could lead to the suggestion for some patients to discontinue a P2Y12 inhibitor, rather than aspirin, in daily clinical practice, which could result in better patient compliance, lower costs, a lower risk of bleeding, and overall, more convenience for both patients and physicians.”