- Heart patients who undergo percutaneous coronary intervention may no longer need to take two types of blood thinners for the next 12 months, according to a new study.
- Blood thinners are prescribed to avoid the formation of blood clots after such procedures, but they carry the risk of bleeding.
- In this study, participants who stopped taking aspirin after one month and continued a second blood thinner for 12 months had no additional cardiac events and had a 55% reduction in bleeding problems. I understand.
If you undergo percutaneous coronary intervention (PCI) to address a heart blockage, your doctor will prescribe two types of antiplatelet drugs, or blood thinners, for 12 months after the procedure. New research suggests blood thinners can be safely cut in half after just one month.
This study showed that after one month of dual anticoagulant therapy, patients were safely anticoagulated without increasing the risk of blood clots forming in the hardware implanted during percutaneous coronary intervention. I learned that I can stop taking the drug.
This research
Although blood thinners provide important protection against the formation of blood clots, they also come with their own risks, such as bleeding, failure to form a scab on the wound, and other side effects.
The combination of antiplatelet drugs after the procedure is called dual antiplatelet therapy or DAPT. It usually contains aspirin and the stronger P2Y.12 There are several types of receptor inhibitors. This study included the use of ticagrelor.
DAPT is prescribed for 12 months. After that period, there is less risk of clotting.
The study looked at medications and outcomes in 3,400 patients with acute coronary syndromes from August 2018 to October 2022 at 58 centers in China, Italy, Pakistan, and the United Kingdom.
All study participants had undergone PCI. They were randomly assigned to one of two groups after stabilizing one month after the procedure. For 1,700 patients, the new “DAPT” was just ticagrelor and a placebo. The remaining patients continued to take ticagrelor and aspirin for 12 months.
Only 35 participants in the ticagrelor plus placebo group had a major or minor bleeding event during the study, compared with 1 month for participants taking ticagrelor plus aspirin. There were 78 people. This corresponds to her 55% reduction in bleeding events.
Major cardiovascular events were statistically similar between the two groups, meaning that discontinuation of aspirin in the ticagrelor and placebo groups did not result in an increase in adverse cardiovascular outcomes.
Dr. Chen Han Chensaid the medical director of the Structural Heart Program at MemorialCare Heart and Vascular Institute at Saddleback Medical Center in Laguna Hills, Calif., who was not involved in the study. Today’s medical news:
“There are two things you can do to solve the problem of clogged arteries. In the past, the only option was bypass surgery, where a surgeon would actually go and reroute all the blood supply around the blockage. ”
“[F]For the past 30 years, something called percutaneous coronary intervention has been performed. It is a minimally invasive procedure that involves passing a small plastic tube called a catheter through the groin or wrist to the heart and using wires, balloons, and wires.
Blood clots that form around these wires, balloons, and stents are why patients are prescribed DAPT. Such clots can block blood flow and cause ischemic phenomena.
“Percutaneous coronary intervention is now a very common technique,” Chen said, because it is much less invasive than bypass surgery.
“Percutaneous coronary interventions are performed every day in every hospital,” Chen said.
This study addresses a balancing challenge that cardiologists have long grappled with. Dr. Jane MorganA cardiologist and executive director of health and community education at Piedmont Healthcare Corporation in Atlanta, Georgia, who was not involved in the study, also explained the dilemma.
“Despite the prevention of ischemic events being the main objective of DAPT, there are some concerns regarding DAPT after PCI in patients with both acute and chronic coronary syndromes, as the risk-benefit balance is considered. There is a debate,” she told MNT.
“It’s clear that we have to reduce the risk of further ischemia,” she says. “On the other hand, what is the cost of increased blood loss and associated increased patient morbidity?”
Morgan cited two studies. Pegasus_Timi 54 and
Morgan said the results were convincing and he looked forward to seeing more data on the subject.
“Single platelet therapy with ticagrelor alone from months 1 to 12 appears to have similar MACCE rates.” [major adverse cardiac and cerebrovascular events] There are fewer bleeding complications,” she said.
“This study shows us what we all suspected: that this strategy is effective, even though it is certainly safer than the strategies we currently have.” And secondly, it showed that things weren’t that bad, so the two blood thinners weren’t causing more blood clots to form on the stent. That’s very important information for us,” Chen said.
He noted that administering two doses of blood thinners after PCI has been a strategy that has been in place for decades, and said the situation is not changing anytime soon. However, important advisory bodies such as the American Heart Association, American College of Cardiology, and Society of Cardiovascular Angiography and Interventions revise their guidelines every few years.
“We hope this is a major step toward future guideline changes,” Chen said.
