In patients who receive a modern stent after a heart attack, a three-month treatment with dual antiplatelet therapy does not lead to more complications than with the current standard treatment of twelve months.
This is shown by international research presented by Harry Suryapranata during the cardiology TCT conference in Denver, USA.
The optimal treatment duration with blood thinners after implantation of a stent in patients with acute coronary syndrome is under discussion. We are constantly looking for an optimum between the risk of clotting and bleeding. Longer treatment with the usual two dual antiplatelet therapy reduces the risk of clotting problems (new heart attack, coagulation in the stent), but at the same time increases the risk of bleeding. The current recommendation - using twelve months of dual dual antiplatelet therapy after a stent implant - is based primarily on research with older stents.
Complications equal in both groups
The REDUCE study, which was conducted in 36 hospitals in Europe and Asia, uses a new bioactive stent, which promotes the natural recovery of the vascular wall. The study, which involved nearly 1500 patients, examined the difference between twelve or three months of use of dual antiplatelet therapy in this specific stent.
"The results show that after implantation of this stent, treatment duration of three months is not worse than the usual twelve months," says Harry Suryapranata, principal investigator of the study and professor of cardiology at Radboudumc. "In about 1 in 12 patients, we experienced one of the following complications in the first year after stent implant: deaths, myocardial infarctions, stent thromboses, strokes, new procedures in the treated coronary artery or bleeding complications. Based on these criteria, we saw no difference in complications between the group that was treated for twelve or three months.'
In the Radboudumc the REDUCE study was conducted under the supervision of intervention cardiologist Cyril Camaro and researcher Sander Damen. Camaro: "This research shows that a shorter treatment duration with dual anti-platelet therapy can be considered when needed, even in patients who have had a heart attack." Suryapranata, who presented the results at a conference in Denver: "It is an important and remarkable finding, but larger studies must confirm this hypothesis. Also because we now have many different types of anti-platelet agents. '
Suryapranata H, De Luca G. REDUCE: A Randomized Trial of 3-Month vs 12-Month DAPT After Implantation of a Bioabsorbable Polymer-Based Metallic DES with a Luminal CD34+Antibody Coating in Patients with ACS. Late Breaking Clinical Trial at the 29th annual Transcatheter Cardiovascular Therapeutics scientific symposium, November 1, 2017.
TCT congress: https://www.tctmd.com/news/shortened-dapt-durations-appear-safe-patients-acs-implanted-des
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