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DAPT duration after endovascular intervention did not affect major adverse events

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LAS VEGAS — Major adverse events did not differ for patients undergoing lower-extremity endovascular revascularization regardless of dual antiplatelet therapy, according to findings presented at the Society for Cardiovascular Angiography and Interventions Scientific Sessions.

Swagata Das, MBBS, and colleagues analyzed 334 consecutive patients from the XLPAD registry who underwent endovascular intervention between 2005 and 2013. All patients were prescribed aspirin 81 mg/day to 325 mg/day and either clopidogrel 75 mg/day, ticagrelor (Brilinta, AstraZeneca) 90 mg/day or prasugrel (Effient, Daiichi Sankyo/Eli Lilly) 10 mg/day for up to 12 months after their procedure.

Das, of the VA North Texas Health Care System in Dallas, and colleagues compared outcomes between the 203 patients on DAPT for 3 months or less and the 131 patients on DAPT for more than 3 months.

The primary outcome was a composite of all-cause mortality, nonfatal MI, need for repeat revascularization and unplanned complications.

At 12 months, patients on DAPT for more than 3 months were more likely to achieve event-free survival compared with those on DAPT for 3 months or less (70.3% vs. 59.7%; HR=1.6; 95% CI, 1.08-2.43). However, there was no difference between the groups in major adverse events at 12 months (70.7% vs. 68.8%; HR=0.99; 95% CI, 0.55-1.78), Das said.

Of the patients on DAPT for 3 months or less, 8.9% required amputation within 12 months, compared with 1.5% of those on DAPT for more than 3 months (P=.005), she said. There were no differences between the groups at 12 months in death (P=.118), nonfatal MI (no incidents in either group), stroke (P=1), revascularization (P=.67) or stent thrombosis (P=.095), she said.

Freedom from adverse limb events did not differ between the groups at 12 months (DAPT >3 months, 79%; DAPT ≤3 months, 74.5%; HR=0.88; 95% CI, 0.59-1.31), according to Das. The groups also did not differ in adverse CV events (HR=0.93; 95% CI, 0.65-1.33).

“A limitation is that this was an observational, retrospective analysis,” Das said. “These results are only hypothesis-generating.” – by Erik Swain

For more information:

Das S. Best of the Best Abstracts: Abstract O-006. Presented at: the Society for Cardiovascular Angiography and Interventions Scientific Sessions; May 28-31, 2014; Las Vegas.

Disclosure: Das reports no relevant financial disclosures.