Final Two-Year Results From the Randomized Onyx One Trial in High Bleeding Risk Patients Treated With 1-Month Dapt

Windecker, Stephan; Kedhi, Elvin; Latib, Azeem; Kandzari, David; Kirtane, Ajay J.; Mehran, Roxana; Price, Matthew; Abizaid, Alexandre; Simón, Daniel; Worthley, Stephen G.; Zaman, Azfar; Wetzels, Gwenn; Lung, Te-Hsin; Marx, Steven O.; Ali, Ziad El; Stone, Gregg W.

doi:10.1016/s0735-1097(21)02258-0

Cited by 2 publications

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“…48 At the 2-year follow-up, the incidences of the primary composite endpoints were still similar between groups (21.2% [zotarolimus-eluting stent] versus 20.7% [polymer-free drug-coated stent]; 95% CI −3.1-4.2; P = 0.78). 49 The Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Prolonged DAPT Regimen (MASTER DAPT) trial investigated the high-bleeding risk patients who underwent PCI with the biodegradable-polymer sirolimus-eluting coronary stent Ultimaster (Terumo). The trial compared the 1-month DAPT regimen (abbreviated therapy) with the standard DAPT regimen (2-months DAPT with an indication for oral anticoagulation or 5-months DAPT without an indication for oral anticoagulation).…”

Section: Duration Of Antiplatelet Regimenmentioning

confidence: 99%

Current Perspectives on Antithrombotic Therapy for the Treatment of Acute Coronary Syndrome

Towashiraporn¹,

Krittayaphong²

2022

IJGM

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Acute coronary syndrome (ACS) is one of the leading causes of death worldwide. Percutaneous coronary intervention (PCI) is the treatment of choice for ACS as this procedure reduces the morbidity and mortality rates of patients in clinical trials and daily practice. However, patients with a history of prior ACS who undergo PCI are still at high risk for recurrent major adverse cardiac events (MACE). Because the antithrombotic drugs reduce the rate of MACE and minimize stent-related complications such as target vessel failure or stent thrombosis, the utilization of these agents is the cornerstone treatment for secondary prevention of ACS patients after PCI. Unfortunately, using the antithrombotic agents may be associated with bleeding complications, including major or fatal bleeding. Therefore, premature discontinuation of antithrombotic regimens regarding the hemorrhagic events is sometimes inevitable and possibly leads to fatal complications such as stent thrombosis. To minimize the bleeding issues, shorten antithrombotic regimens have been proposed, which theoretically offers improved safety. Nevertheless, inappropriate withdrawal of antithrombotic drugs may increase the rate of ischemic events. On the other hand, an unnecessary prolonged antithrombotic regimen may cause avoidable bleeding. Balancing the risk of bleeding against the benefits of using antithrombotic drugs is therefore challenging especially for the patients who contain both bleeding and ischemic risks such as ACS patients who are concomitant using the anticoagulants. Currently, the treatment paradigms are shifting from the "one size fits all approach" toward the "tailored approach". This means that the antithrombotic regimens can be adjustable individually. As a result, various clinical risk scoring systems have been established to help physicians with their decision-making. However, besides the development of these dedicated scoring tools, clinical judgment for balancing the safety versus the efficacy before deciding on the antithrombotic plan is still imperative.

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Section: Duration Of Antiplatelet Regimenmentioning

confidence: 99%