HealthDay News – For patients with peripheral arterial disease (PAD), prolonged dual antiplatelet therapy (DAPT) is associated with reduced risk of ischemic events, according to a study published online August 30 in the Journal of the American Medical Association. The research was published to coincide with the 2016 European Society of Cardiology Congress, held from August 27 to 31 in Rome.

Anna Franzone, MD, from Bern University Hospital in Switzerland, and colleagues examined the efficacy and safety of prolonged vs short DAPT in patients with PAD undergoing percutaneous coronary intervention. Data were included for 246 patients with and 1724 patients without PAD.

Researchers found that PAD status correlated with increased risk of death and ischemic events (hazard ratio [HR]: 2.80; 95% confidence interval [CI], 2.05-3.83). Prolonged vs short DAPT correlated with a reduced risk of the primary efficacy end point (composite of death, myocardial infarction, or cerebrovascular accidents) in patients with PAD (16.1% vs 27.3%; HR: 0.54; 95% CI: 0.31-0.95), but not in patients without PAD (9.3% vs 7.4%; HR: 1.28; 95% CI, 0.92-1.77), with a positive interaction (P= .01). Patients with PAD treated with prolonged vs short DAPT had significantly lower risk of definite or probable stent thrombosis (HR: 0.07; 95% CI: 0-1.21).


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“Prolonged DAPT lowers the risk of ischemic events with no apparent bleeding liability in this high-risk group,” the authors wrote

Disclosures: One author disclosed financial ties to the pharmaceutical and medical device industries.

References

  1. Bonaca MP. Antithrombotic therapy in patients with peripheral artery disease. JAMA Cardiol. 2016. doi:10.1001/jamacardio.2016.2797. 
  2. Franzone A, Piccolo R, Gargiulo G, et al. Prolonged vs short duration of dual antiplatelet therapy after percutaneous coronary intervention in patients with or without peripheral arterial disease. A subgroup analysis of the PRODIGY randomized clinical trial. JAMA Cardiol. 2016. doi:10.1001/jamacardio.2016.2811.
  3. Franzone A, Piccolo R, Gargiulo G, et al. Abstract 5154. Prolonged vs short duration of dual antiplatelet therapy after percutaneous coronary intervention in patients with or without peripheral arterial disease. Presented at European Society of Cardiology Congress. August 27-31, 2016; Rome, Italy.