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Journal Club: Drs. Drew Klein and Raj Patel Review DAPT

from SCAI

Join Andrew Klein, MD, FSCAI, of John Cochran VA Medical Center in St. Louis and Rajan Patel, MD, FSCAI, of Ochsner Medical Center in New Orleans as they review a case illustrating the findings from "Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents," appearing in the Dec. 4, 2014, issue of The New England Journal of Medicine.

This study looked at 9,961 patients who underwent DES placement without complications during 12 months of dual antiplatelet therapy (DAPT) with ASA and either Plavix or Prasugrel. After this 12-month period, patients were randomized to an additional 18 months of aspirin alone or aspirin alone plus clopidogrel/prasugrel with primary efficacy endpoints of definite or probable stent thrombosis and major adverse cardiovascular and cerebrovascular events (MACCE). The primary safety endpoint was moderate or severe bleeding. The study showed decreases in stent thrombosis and MACCE amongst the group undergoing prolonged DAPT. However, this group also experienced a greater number of moderate or severe bleeding.

In light of this study, Drs. Klein and Patel review the clinical vignette to the right and ask the following questions:
  • What would you recommend as the optimal duration of DAPT in this patient?
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