Shorter Dual Antiplatelet Therapy May Offer Safety Benefits In Myocardial Infarction Patients

Three months of dual antiplatelet therapy (DAPT) was associated pinch signals suggesting improved endurance and little bleeding consequence than 12 months of DAPT, successful a real-world all-comer organization of patients pinch myocardial infarction (MI), according to late-breaking investigation presented successful a Hot Line convention coming astatine ESC Congress 2025.

In patients aft a bosom attack, nan first 1-3 months is associated pinch nan highest consequence of recurrent events. Evidence indicates that compared to nan line recommendations of 12 months of DAPT, shorter DAPT durations person balanced efficacy successful reducing recurrent events, pinch a little consequence of awesome bleeding and a inclination towards little decease rates successful MI patients treated pinch stents. We truthful conducted nan DUAL-ACS proceedings to analyse nan effect of 3 months vs. 12 months of DAPT successful a real-world organization of patients pinch MI, treated pinch stents, bypass grafting aliases aesculapian therapy alone."

David Newby, Principal Investigator, Professor, University of Edinburgh, UK

DUAL-ACS was an open-label, investigator-initiated, randomized trial. The proceedings was initially conducted successful Scotland. However, nan COVID-19 pandemic had an adverse effect connected recruitment. Patients from England and New Zealand were past recruited. Eligible patients had had a type 1 MI wrong 12 weeks and required DAPT (aspirin and a P2Y12 inhibitor) successful nan sentiment of nan attending clinician. Patients were randomized 1:1 to either 3 aliases 12 months of DAPT. All patients were managed according to section objective practice. Hospital admittance statistic and mortality were obtained done routinely collected wellness records data. The superior endpoint was all-cause mortality.

A full of 5,052 patients were randomized who had a mean property of 63 years and 27% were female. Following nan scale admission, 23% received aesculapian guidance only, 70% underwent percutaneous coronary involution and 6% had coronary artery bypass graft surgery.

After follow-up of 15 months, nan superior endpoint of all-cause mortality occurred successful 2.7% of patients successful nan 3-month DAPT group and 3.4% of patients successful nan 12-month DAPT group (hazard ratio [HR] 0.78; 95% assurance interval [CI] 0.57 to 1.07; p=0.1232) pinch nary quality successful cardiovascular decease aliases non-fatal MI (HR 1.04; 95% CI 0.87 to 1.26; p=0.6149).

Fatal and non-fatal awesome bleeding occurred successful 3.2% of patients successful nan 3-month DAPT group and 4.0% of patients successful nan 12-month DAPT group (HR 0.78; 95% CI 0.58 to 1.06; p=0.0977).

In conclusion, Professor Newby said: "This all-comer real-world proceedings recruited only 30% of nan planned participants and was incapable to reside nan superior mobility definitively. However, location was nary grounds that DAPT fixed for 12 months conferred immoderate further benefit. Indeed, nan trends for little mortality and bleeding consequence pinch 3 months of DAPT are accordant pinch anterior meta-analyses and propose that limiting DAPT long to 3 months whitethorn beryllium safer successful a real-world modern population."