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CV and Bleeding Events After Coronary Stenting

JAMA Cardiol; ePub 2017 Mar 15; Secemsky, et al

There was a high risk of mortality among patients treated with dual antiplatelet therapy (DAPT) for at least 1 year after coronary stenting, with ischemic events more frequent than bleeding events, a recent study found. The secondary analysis of the Dual Antiplatelet Therapy (DAPT) Study enrolled 25,682 patients from 220 US and international clinical sites from 11 countries. Study dates were August 2009 to May 2014. Patients who underwent coronary stenting and completed 12 months of thienopyridine plus aspirin therapy without ischemic or bleeding events remained on an aspirin regimen and were randomized to continue thienopyridine therapy vs placebo for 18 additional months. Follow-up continued for 3 months with aspirin therapy alone. Researchers found:

  • 11,648 patients (mean age 61.3 years; 25.1% female) were randomized.
  • Ischemic events occurred in 4% of patients; 11% died, and the cumulative incidence of death after an ischemic event was 0.5%.
  • Bleeding events occurred in 2% of patients; 18% died, and the cumulative incidence of death after a bleeding event was 0.3%.

Citation:

Secemsky EA, Yeh RW, Kereiakes DJ, et al. Mortality following cardiovascular and bleeding events occurring beyond 1 year after coronary stenting. A secondary analysis of the Dual Antiplatelet Therapy (DAPT) Study. [Published online ahead of print March 15, 2017]. JAMA Cardiol. doi:10.1001/jamacardio.2017.0063.

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