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Dual better than triple antithrombotic therapy after percutaneous coronary intervention

10 Mar 2018

Compared to triple therapy, dual antithrombotic therapy yields reduced bleeding without excess ischaemic and thromboembolic cardiac events in patients with long-term indication to chronic oral anticoagulation (OAC) following percutaneous coronary intervention (PCI), according to a new study.

The researchers performed a meta-analysis of four randomized controlled trials (n=6,036) receiving chronic OAC after PCI. Incidences of major and minor bleeding, myocardial infarction, stroke and all-cause death, among other outcomes, were compared between those receiving dual and triple therapy.

Over the mean follow-up duration of 11.7 months, the incidence of major bleeding was 1.97 percent in patients receiving dual therapy, lower than the 3.53 percent in those on triple therapy. This finding yielded a significant 45-percent decrease in relative risk (p=0.0007).

A similar trend was observed with minor bleeding, where the relative risk was 43 percent lower with the dual vs triple therapy (3.30 percent vs 7.18 percent; p=0.00001).

Incidence of the other endpoints, such as all-cause mortality (3.81 percent vs 4.01 percent; p=0.37) and cardiovascular mortality (1.62 percent vs 2.02 percent; p=0.42) were statistically comparable between the dual and triple therapies.

“In conclusion, this large study level meta-analysis on patients candidates to OAC, mainly for AF, and undergoing PCI indicates that dual antithrombotic therapy significantly reduces major and minor bleeding compared to triple therapy,” said researchers, noting that the findings translated to 15 major and 39 minor bleeding events per 1,000 patients at 1 year, were prevented by dual therapy.

“Interestingly, the use of dual therapy led to a numerically lower mortality, although not statistically significant, probably due to the low number of events,” they added, emphasizing that limitations, such as lack of access to individual information and scarcity of available studies, warrant further, larger investigations.

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Most Read Articles
18 Apr 2018
Higher intake levels of coffee appear to be associated with reduced risk of developing chronic kidney disease, according to data from the Atherosclerosis Risk in Communities Study.
Jairia Dela Cruz, 6 days ago
Infants delivered via caesarean section may be at increased risk of developing acute lymphoblastic leukaemia, according to a US study. Altered microbiota colonization is a possible explanation for this risk, although clear biological mechanisms have yet to be established.
5 days ago
Treatment with danegaptide does not improve myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention, according to the results of a phase II study.
Pearl Toh, 3 days ago
Tai Chi may be equivalent to pulmonary rehabilitation (PR) in improving health status of patients with chronic obstructive pulmonary disease (COPD), a recent study shows.