Late Breaking Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Dual antiplatelet therapy (DAPT), comprising aspirin and a P2Y12 inhibitor, has been recommended for preventing secondary cardiovascular events following percutaneous coronary intervention (PCI). However, variations in DAPT have also been used in clinical practice
Research Question or Hypothesis: After the initial 90-day post-PCI, SAPT and DAPT have the same effects on prevention of the secondary cardiovascuar events
Study Design: Retrospective cohort study using real-world claim data
Methods: Claims data from the Health Insurance Review and Assessment Service were used in this study. Clinical outcomes, including net adverse clinical events (NACE) such as death, myocardial infarction, ischemic stroke, revascularization, and bleeding were assessed at 12 and 24 months (M) after PCI. The adjusted Hazard ratios (aHR) of NACE in SAPT versus DAPT groups were compared
Results: The results identified 232,760 patients diagnosed with ACS who underwent PCI between 2015 and 2020. The initial 90-day post-PCI DAPT usage was reported with 183,910 (79.01%) in the aspirin + clopidogrel (AC), 37,290 (16.02%) in the aspirin + ticagrelor (AT), and 11,560 (4.97%) in the aspirin + prasugrel (AP) group out of total patients. The continuous use of DAPT was 145,134 (81.41%) in AC, 24,239 (17.60%) in AT, and 8,889 (4.99%) in AP group out of 178,262 patients excluding the switcher to other antiplatelets.The SAPT use after 90 days post-PCI was 6,338 in C, 1,063 in T, and 100 in P groups out of 7,501 patients excluding the switch to other antiplatelets.The aHR of NACE in the overall SAPT compared to DAPT was 1.05 (95% CI, 0.99-1.11, p=0.11) at 12M post-PCI and 0.99 (95% CI, 0.95-1.04, p=0.79) at 24M post-PCI.
Conclusion: The study found no significant difference in overall clinical outcomes between DAPT and SAPT. However, Individual agents of SAPT and DAPT have shown some disparities. This suggests that SAPT may be the possible option for some patients, with various therapeutic considerations
Presenting Author
Sukhyang Lee PharmD, PhDAjou University
Authors
Eunjung Choo MS
Ajou University
Sunok Chung BS
Ajou University