DAPT Discontinuation, Platelet Reactivity, and Adverse Outcomes After PCi

This post hoc analysis of the ADAPT-DES study investigated the predictors of dual antiplatelet therapy (DAPT) discontinuation, associations between different types and timing of DAPT discontinuation with thrombotic events, and the impact of on-treatment high platelet reactivity in 8582 patients who were already receiving aspirin and clopidogrel after undergoing PCI. In result it was seen that approximately 50% of patients discontinued DAPT within 2 years, with unplanned DAPT discontinuation occurring in 16.5% of patients and discontinuation of both aspirin and clopidogrel occurring in 29.8% of patients. Also, unplanned discontinuation was associated with a significantly increased risk of a major adverse cardiac event, with the highest risk occurring in the first 7 days after DAPT discontinuation, within 90 days of PCI, and when both antiplatelet agents were discontinued. In this large-scale all-comers registry, premature DAPT discontinuation for unplanned reasons occurred in approximately 1 of 6 patients after DES implantation and was associated with a markedly increased risk of MACEs. These findings suggest that unplanned DAPT discontinuation after PCI leads to worse clinical outcomes. Strategies for better identification of patients at risk for premature DAPT discontinuation are warranted to mitigate adverse outcomes. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.