It has been proposed that one should err on the side of short-term therapy for patients at high risk of bleeding
Discussions regarding late-breaking cardiovascular clinical trials among leading medical scientists are placing considerable emphasis on individualised patient care, particularly in the area of dual antiplatelet therapy, according to an analyst with research and consulting firm GlobalData.
At the recent 2014 American Heart Association (AHA) meeting in Chicago, the results of the Dual Antiplatelet Therapy (DAPT) Study played a central role in presentations and debates regarding the use of antiplatelet blood-thinning agents.
Eric J Dimise, analyst, GlobalData’s covering cardiovascular and metabolic disorders, states that the DAPT Study attempted to address a key outstanding question concerning how long physicians should apply dual antiplatelet therapy following implantation of a drug eluting stent (DES), with leading investigators concluding that the solution may depend upon individual patient needs.
Dimise says, “The study revealed that treatment with dual antiplatelet therapy (aspirin and clopidogrel or prasugrel) decreased the risk of stent thrombosis and major cardiovascular and cerebrovascular events, compared to treatment with aspirin alone during the 12 to 30-month period following implantation of a DES. However, this was achieved at the price of an increased frequency of bleeding.
“As a consequence, the debate now focuses on how physicians should strike a balance between reducing cardiovascular events while simultaneously minimising bleeding risk.”
According to the analyst, it has been proposed that one should err on the side of short-term therapy for patients at high risk of bleeding, while therapy beyond 12 months should be considered for those at high risk of a recurrent ischemic event.
However, cases have been presented in favour of both short and long-term therapies, with the former leaning on the resultant diminution of bleeding events observed in the placebo group of the DAPT Study, and the latter arguing for the clear cardiovascular event-reduction benefit.
EP News Bureau – Mumbai