A study published in the Lancet says that when a person receives a percutaneous coronary intervention to address a heart blockage, doctors prescribe antiplatelet drugs or blood thinners for 12 months post-procedure. This research suggests that such blood thinners can be cut in half after one month of consumption.
This study concluded that after one month of dual blood thinners, patients can stop taking one without experiencing an increased risk of clots forming on the hardware implanted during percutaneous coronary intervention. Even though blood thinners offer important protection against clot formation, they have their own risks, like bleeding, which is an inability to form scabs over wounds, and other adverse reactions.
The mix of post-procedure antiplatelet medications is called dual antiplatelet therapy or DAPT. It typically contains aspirin and a more potent P2Y12 receptor inhibitor, of which there are several. The study involved the use of ticagrelor.DAPT is prescribed for 12 months because, after that period, there is less risk of clotting. Researchers looked at medications and outcomes for 3400 patients with acute coronary syndrome.
All study participants had received PCI and were randomly assigned to one of the two groups after being stable for one month post-procedure. For 1700 patients, the new DAPT was ticagrelor and a placebo. The remaining individuals remained on ticagrelor and aspirin for the full 12 months. Participants in the ticagrelor-placebo group, just 35, had major or minor bleeding events during the study, compared to 78 of the individuals taking ticagrelor-aspirin after one month. This amounts to a 55% reduction in bleeding events.
Major cardiovascular events were statistically similar between the two groups, meaning the cessation of aspirin in the ticagrelor-placebo group did not increase adverse cardiovascular outcomes.
Blood clots forming around these wires, balloons, and stents are why patients are prescribed DAPT. Such clots can block the flow of blood, resulting in ischemic events. Percutaneous coronary intervention is a widespread technique now. Even though prevention of ischemic events is the primary purpose of DAPT, there has been some debate regarding DAPT following PCI in patients with both acute and chronic coronary syndromes, as the risk-benefit balance is weighed.
Researchers say that Single-Action Platelet Therapy with ticagrelor alone between months 1 and 12 resulted in a similar rate of MACCE [major adverse cardiac and cerebrovascular events] with lower bleeding complications. This study shows that this strategy is effective, even though it’s definitely a safer strategy than what we’re all doing now. And number two, it showed that it wasn’t worse. It wasn’t causing more clots to form on the stent, which you gave the two blood thinners.
Journal Reference – (N.d.). Retrieved from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00473-2/abstract
