Abstract:

This review delves into the discussion of the "Effect of dual antiplatelet therapy prolongation in acute coronary syndrome patients with both high ischemic and bleeding risk" explored in the OPT-CAD study. The research was directed at identifying patients with acute coronary syndrome who presented a bi-risk profile of high ischemic and bleeding risks and further evaluated the safety and efficacy of extended use of DAPT beyond 12 months post-PCI. The current review, through post hoc analysis of the OPT-CAD trial data, discusses the five-year incidence of ischemic and bleeding events in bi-risk patients. Indeed, extended DAPT has reduced the incidence of stroke without significant major bleeding risks. This review will cover the methodology of the findings presented, the results, and their clinical implication in real-world practice for the management of ACS.

References:

[1].      Na, K., Qiu, M., Wei, N., Li, J., Yan, C., Li, J., Li, Y., Han, Y., 2023, Effect of dual antiplatelet therapy prolongation in acute coronary syndrome patients with both high ischemic and bleeding risk: insight from the OPT-CAD study. Frontiers in Cardiovascular Medicine, 10, 1201091.

[2].      Huo, Y., Lee, S. W., Sawhney, J. P. S., Kim, H. S., Krittayaphong, R., Pocock, S. J., et al., 2020, Two-year outcomes post-discharge in Asian patients with acute coronary syndrome: findings from the EPICOR Asia study. International Journal of Cardiology, 315, 1–8. doi: 10.1016/j.ijcard.2020.05.022.

[3].      Angiolillo, D. J., Galli, M., Collet, J. P., Kastrati, A., O’Donoghue, M. L., 2022, Antiplatelet therapy after percutaneous coronary intervention. EuroIntervention, 17, e1371–e1396. doi: 10.4244/EIJ-D-21-00904.

[4].      Collet, J. P., Thiele, H., Barbato, E., Barthelemy, O., Bauersachs, J., Bhatt, D. L., et al., 2021, 2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal, 42, 1289–1367. doi: 10.1093/eurheartj/ehaa575.

[5].      Valgimigli, M., Frigoli, E., Heg, D., Tijssen, J., Juni, P., Vranckx, P., et al., 2021, Dual antiplatelet therapy after PCI in patients at high bleeding risk. New England Journal of Medicine, 385, 1643–1655. doi: 10.1056/NEJMoa2108749.

[6].      Wang, H. Y., Gao, R. L., Xu, B., Yang, Y. J., Yin, D., Wang, Y., et al., 2021, Benefit-risk profile of extended dual antiplatelet therapy beyond 1 year in patients with a high risk of ischemic or bleeding events after PCI. Platelets, 32, 533–541. doi: 10.1080/09537104.2020.1774052.