Study Evaluates Risks and Benefits of Prolonged DAPT After Stenting in Women

August 13, 2018—An analysis of the benefits and risks of prolonged dual antiplatelet therapy (DAPT) after coronary stenting in women was conducted by the DAPT study investigators.

The investigators concluded that women had similar late risks (12–30 months) of ischemia and bleeding as men after coronary stenting procedures. The findings were published online in Circulation: Cardiovascular Interventions by Natalia C. Berry, MD, et al for the DAPT study investigators.

The DAPT study is a randomized, double-blind, placebo-controlled trial comparing continued thienopyridine versus placebo beyond 12 months after coronary stenting. In the study population of 11,648 patients, women (n = 2,925) were older, had a higher prevalence of diabetes mellitus, and lower rates of acute coronary syndrome than men.

As reported in Circulation: Cardiovascular Interventions, the DAPT study investigators found the effects of continued thienopyridine therapy did not differ significantly by sex in terms of:

• Stent thrombosis (women: hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.22–1.36; men: HR, 0.26; 95% CI, 0.15–0.44; interaction P = .17)
• Myocardial infarction (women: HR, 0.75; 95% CI, 0.50–1.14; men: HR, 0.46; 95% CI, 0.36–0.60; interaction P = .052)
• Major adverse cardiovascular and cerebrovascular events (women: HR, 0.87; 95% CI, 0.62–1.22; men: HR, 0.70; 95% CI, 0.58–0.85; interaction P = .26)
• Bleeding (women: HR, 1.45; 95% CI, 0.88–2.40; men: HR, 1.78; 95% CI, 1.28–2.49; interaction P = .5)