As drug-eluting stent technology has evolved, stent thrombosis has become less of a risk and the standard recommendation of 1 year of dual antiplatelet therapy after PCI is being challenged, especially for patients at high bleeding risk.
Healio was on-site at TCT 2019, which offered a number of late-breaking presentations on optimizing pharmacotherapy after PCI. Below are some of the highlights.
TWILIGHT: Switching to ticagrelor monotherapy 3 months post-PCI lowers bleeding vs. DAPT
SAN FRANCISCO — Among patients who underwent PCI with a DES and were prescribed DAPT for 3 months, subsequent ticagrelor monotherapy lowered bleeding risk without raising ischemic risk compared with continued DAPT, according to results of the TWILIGHT trial presented at TCT 2019.
Durable-polymer DES noninferior to polymer-free DCS in patients with high bleeding risk, shorter DAPT: Onyx ONE
SAN FRANCISCO — In the first randomized trial to compare a durable-polymer DES with a polymer-free drug-coated stent in patients with high bleeding risk who received 1 month of DAPT, treatment with the DES was as safe and effective as treatment with the drug-coated stent, according to results of the Onyx ONE trial presented at TCT 2019.
AUGUSTUS: Benefit of dual therapy with apixaban, P2Y12 inhibitor consistent across subgroups
SAN FRANCISCO — New data from the AUGUSTUS trial provide insight on the appropriate antithrombotic regimen after ACS or PCI in patients with atrial fibrillation, irrespective of treatment with medical therapy or elective PCI.
IDEAL-LM: Newer EES plus shortened DAPT similar to older EES plus 1-year DAPT in left main disease
SAN FRANCISCO — Among patients with CAD in the left main artery who underwent PCI, a biodegradable polymer everolimus-eluting stent plus 4 months of DAPT conferred similar outcomes as a durable polymer EES plus 1 year of DAPT, according to results from the IDEAL-LM trial.
MODEL U-SES: 3-month DAPT noninferior to standard DAPT after PCI with bioresorbable SES
SAN FRANCISCO — Among patients who underwent PCI with a bioresorbable polymer sirolimus-eluting stent, 3-month DAPT was noninferior to longer DAPT, according to results from the MODEL U-SES study.