Risk for major adverse cardiac and cerebrovascular events lower compared with aspirin monotherapy for patients who undergo PCI and discontinue DAPT<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b>
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FRIDAY, June 6, 2025 (HealthDay News) — For patients who undergo percutaneous coronary intervention (PCI) and discontinue dual antiplatelet therapy (DAPT), P2Y12<\/sub> inhibitor monotherapy is associated with a lower risk for major adverse cardiac and cerebrovascular events (MACCE) compared with aspirin, according to a meta-analysis published online June 4 in The BMJ<\/em>.<\/p>\n Daniele Giacoppo, M.D., Ph.D., from the University of Catania in Italy, and colleagues examined the long-term comparative effectiveness of P2Y12 <\/sub>inhibitor monotherapy versus aspirin monotherapy in patients with PCI and discontinuation of DAPT in an individual participant data meta-analysis of randomized clinical trials. Five randomized trials that included 16,117 patients assigned to P2Y12<\/sub> inhibitor or aspirin monotherapy after PCI and completion of the recommended DAPT regimen were included.<\/p>\n The researchers found that at a median follow-up of 1,351 days, P2Y12<\/sub> inhibitor monotherapy was associated with a lower risk for MACCE versus aspirin monotherapy (one-stage analysis: hazard ratio, 0.77; multivariable one-stage analysis: adjusted hazard ratio, 0.77; two-stage analysis: hazard ratio, 0.77), yielding a number needed to treat to benefit of 45.5. There was no significant difference seen in major bleeding. Compared with those assigned to aspirin, patients assigned to a P2Y12<\/sub> inhibitor had a lower net composite of adverse cardiac and cerebrovascular events, myocardial infarction, and stroke. Across multiple sensitivity and subgroup analyses, these findings were confirmed.<\/p>\n “Our data add to previous findings because this is the first meta-analysis including exclusively patients who underwent PCI, providing long term follow-up information and relying on individual participant data from all available PCI trials with contemporary P2Y12<\/sub> inhibitors,” the authors write.<\/p>\n Several authors disclosed ties to the pharmaceutical industry.<\/p>\n