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ACP Journal Club |17 March 2015

Dual antiplatelets for 30 mo after drug-eluting stents reduced stent thrombosis and CV and cerebrovascular events

Frederick A. Spencer, MD; Gordon Guyatt, MD

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Mauri L, Kereiakes DJ, Yeh RW, et al; DAPT Study Investigators. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med. 2014;371:2155-66. 25399658

GIM/FP/GP:

Cardiology:

Hematol/Thrombo:

After implantation of drug-eluting stents, what is the efficacy and safety of 30 versus 12 months of dual antiplatelet therapy?
12-month open-label period followed by 18-month, randomized, placebo-controlled trial (Dual Antiplatelet Therapy [DAPT] study). ClinicalTrials.gov NCT00977938.
Concealed.*
Blinded* ({patients, health care providers, data collectors, data analysts}†, and outcome assessors).
12 to 30 months.
452 sites in 11 countries.
9961 patients > 18 years of age (mean age 62 y, 75% men) who received a drug-eluting stent (DES) followed by 12 months of open-label aspirin plus a thienopyridine (clopidogrel or prasugrel); had adequate adherence (80% to 120% of doses, without an interruption for > 14 d); and did not have a major adverse cardiovascular or cerebrovascular event, repeat revascularization, or moderate or severe bleeding during the 12-month phase. Exclusion criteria included percutaneous coronary intervention or cardiac surgery between 6 weeks and 12 months after stent placement, or use of warfarin or an anticoagulant.
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Spencer FA, Guyatt G. Dual antiplatelets for 30 mo after drug-eluting stents reduced stent thrombosis and CV and cerebrovascular events. Ann Intern Med. ;162:JC9. doi: 10.7326/ACPJC-2015-162-6-009

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Published: Ann Intern Med. 2015;162(6):JC9.

DOI: 10.7326/ACPJC-2015-162-6-009

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