Author + information
- Amneet Sandhu,
- Patrick Stewart,
- Steven Bradley,
- Robert Yeh,
- John Messenger,
- James de Lemos,
- Michael Ho,
- Javier Valle,
- Gregory Hess,
- John Rumsfeld,
- Frederick Masoudi and
- Thomas Maddox
Background: The Dual Antiplatelet (DAPT) trial demonstrated DAPT beyond 12 months post-PCI reduced ischemic events at the risk of increased bleeding. We determined “real world” applicability of the DAPT trial by assessing current patterns of P2Y12 therapy, predictors of extended use and compared our data to the recently published DAPT score.
Methods: Using CathPCI® registry data linked to pharmaceutical data, we identified patients who underwent PCI between 2009-2011 and met DAPT trial inclusion criteria. We determined the proportion on extended P2Y12 therapy (>12 months post-PCI) and evaluated associations between extended drug therapy, ischemic-bleeding risk factors and individual DAPT scores.
Results: Among 1,044,863 patients, 20.5% (213,758) met DAPT trial inclusion criteria and of these patients, 53.7% (114,956) received extended P2Y12 therapy. The figure shows rates of extended drug use beyond 12 months. Ischemic-bleeding factors associated with extended drug use included paclitaxel-eluting stent (OR 1.39 [1.34-1.44]), prior PCI or MI (OR 1.27 [1.25-1.30]) and vein-graft PCI (OR 1.20 [1.13-1.27]). Increasing DAPT score correlated with higher rates of extended drug use (p<0.0001).
Conclusions: In current practice, less than 1 in 4 patients met DAPT trial inclusion criteria and half of these patients received extended P2Y12 therapy. Predating DAPT score publication, our results suggest clinicians appropriately weigh ischemic-bleeding tradeoffs when applying extended P2Y12 therapy.
Moderated Poster Contributions
Acute and Stable Ischemic Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 12:45 p.m.-12:55 p.m.
Session Title: Anti-Platelet Therapies: Always a Sticky Topic
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1227M-05
- 2017 American College of Cardiology Foundation