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February 6, 2026European Heart Journal

DAPT pretreatment before CCS and NSTEMI PCI is linked to ~65% less in-hospital stent thrombosis.

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Why the study?

The optimal timing for initiating P2Y12 inhibitor therapy in patients undergoing PCI remains controversial.

Does DAPT pretreatment reduce in-hospital stent thrombosis and improve clinical outcomes in patients with CCS and NSTEMI undergoing PCI?

Population

44412 patients (53898 PCI procedures) with CCS and NSTEMI in the France PCI registry

Comparison

DAPT pretreatment vs no pretreatment

Design

Registry-based cohort study

Follow-up

One year

Key result

DAPT pretreatment in patients undergoing PCI for CCS and NSTEMI was associated with a significantly lower incidence of in-hospital stent thrombosis (0.1% vs. 0.4%; OR 0.35, 95% CI 0.22-0.57).

Authors

GRGrégoire RangéGCG CaylaDAD Angoulvant

Discussion

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Overview

Supports DAPT pretreatment to reduce stent thrombosis in PCI; extends observational data but leaves open need for RCTs.

Key Points

  • This study analyzes how dual antiplatelet therapy pretreatment affects stent thrombosis in PCI patients.
  • Analyzed data from 53,898 PCI procedures in the France PCI registry from 2014 to 2020.
  • Divided patients into pretreatment (83.2%) and no pretreatment (16.8%) groups.
  • Primary endpoint assessed was the incidence of in-hospital definite stent thrombosis.
  • Pretreatment group had a lower in-hospital stent thrombosis incidence (0.1% vs. 0.4%; OR: 0.35).
  • At one year, pretreatment was associated with lower major adverse cardiovascular events (6.6% vs. 7.8%; OR: 0.83).
  • All-cause mortality was lower in the pretreatment group (4.6% vs. 6.0%; OR: 0.71).

Study Design

Type

Cohort (n=44,412)

Multicenter

Yes

Structured PICO

Does DAPT pretreatment reduce in-hospital stent thrombosis and improve clinical outcomes in patients with CCS and NSTEMI undergoing PCI?

P
Population
44,412 patients (53,898 PCI procedures) with chronic coronary syndrome (CCS) and NSTEMI treated by percutaneous coronary intervention (PCI) from the France PCI registry between 2014 and 2020.
I
Intervention
Dual antiplatelet therapy (DAPT) pretreatment (P2Y12 inhibitor therapy initiated before PCI)
C
Comparator
No DAPT pretreatment
O
Outcome
Incidence of in-hospital definite stent thrombosishard clinical

Main Result

Effect estimate: OR 0.35 (95% CI 0.22 to 0.57)

Absolute Event Rate: 0.1% vs 0.4%

In a large real-world registry of patients undergoing PCI for CCS or NSTEMI, DAPT pretreatment significantly reduced in-hospital stent thrombosis and 1-year mortality without increasing major bleeding risk.

Cite This Study

Rangé et al. (2025) conducted a cohort in CCS and NSTEMI treated by PCI (n=44,412). Dual antiplatelet therapy (DAPT) pretreatment vs. No pretreatment was evaluated on Incidence of in-hospital definite stent thrombosis (OR 0.35, 95% CI 0.22 to 0.57). DAPT pretreatment in patients undergoing PCI for CCS and NSTEMI was associated with a significantly lower incidence of in-hospital stent thrombosis (0.1% vs. 0.4%; OR 0.35, 95% CI 0.22-0.57).

synapsesocial.com/papers/698586238f7c464f2300a139https://doi.org/10.1093/eurheartj/ehaf784.3125
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