Short-duration triple antithrombotic therapy (<7 days) after PCI showed no statistically significant differences in cardiovascular events or major bleeding at 1 year compared to extended duration.
Observational (n=172)
No
Does short-duration triple antithrombotic therapy (< 7 days) improve clinical outcomes compared to extended-duration (≥ 7 days) in patients requiring oral anticoagulation after PCI?
Early de-escalation of triple antithrombotic therapy to under 7 days post-PCI in patients requiring oral anticoagulation appears safe and effective, with similar ischemic and bleeding outcomes compared to extended duration.
BACKGROUND: Balancing ischemic and bleeding risks in patients undergoing percutaneous coronary intervention (PCI) who require anticoagulation remains a clinical challenge. While dual antithrombotic therapy (DAT) with a P2Y12 inhibitor and an oral anticoagulant reduces long-term bleeding risk, the optimal duration of triple antithrombotic therapy (TAT) in the immediate post-procedural phase is uncertain. AIMS: We aimed to evaluate clinical outcomes of short-duration ({7 days) of TAT to extended-duration (≥ 7 days) of triple therapy following PCI. METHODS: We conducted a retrospective observational study of 172 patients who underwent PCI. Of these, 109 received TAT for 3) and intracranial hemorrhage. RESULTS: There were no statistically significant differences between the two groups in composite outcome (cardiovascular mortality, myocardial infarction, target vessel revascularization, or stent thrombosis at 1 year). Similarly, rates of major bleeding events did not differ significantly between the groups. CONCLUSION: Early de-escalation of TAT (within 7 days) demonstrated similar clinical outcomes to longer durations (< 7 days). Larger randomized controlled trials are warranted to further validate these findings.
Kurpad et al. (Sun,) conducted a observational in Patients requiring oral anticoagulation undergoing percutaneous coronary intervention (PCI) (n=172). Short-duration (< 7 days) triple antithrombotic therapy vs. Extended-duration (≥ 7 but < 28 days) triple antithrombotic therapy was evaluated on Composite endpoint of cardiovascular mortality, myocardial infarction, target lesion revascularization, and definite or probable stent thrombosis at 1 year. Short-duration triple antithrombotic therapy (<7 days) after PCI showed no statistically significant differences in cardiovascular events or major bleeding at 1 year compared to extended duration.