6/28/23, 1:15 AM DAPT Pathway Feedback Search Clinical Topics Home Studies DAPT DAPT Disease Disease Disease Coronary artery disease Non-ST-elevation myocardial inf ST-elevat Trial question What is the role of dual antiplatelet therapy beyond 12 months in patients who had undergone a coronary stent procedure in which drug-eluting stent was placed? Study design Multi-center Double blinded RCT Population Characteristics of study participants 25.0% female N = 9961 75.0% male 9961 patients (2526 female, 7435 male) Inclusion criteria: patients who underwent a coronary stent procedure in which a drug-eluting stent was placed and who were treated with a thienopyridine drug (clopidogrel or prasugrel) and aspirin for 12 months Key exclusion criteria: pregnant women, concurrent medical condition with a life expectancy of < 3 years, index procedure stent placement with stent diameter < 2.25 mm or > 4.0 mm, long-term warfarin therapy, hypersensitivity or allergy to one of the study drugs Interventions N=5020 continued thienopyridine (continued clopidogrel or prasugrel plus aspirin for 18 months) N=4941 placebo (aspirin therapy alone for 18 months) https://web.pathway.md/studies/recPhyczxUeHQHD4Y 1/2 6/28/23, 1:15 AM DAPT Pathway Primary outcome Stent thrombosis 1.4 % 1.4 1.0 % 0.7 % Significant decrease 0.4 0.3 % NNT = 100 0.0 % Continued thienopyridine Placebo Significant decrease in stent thrombosis (0.4% vs. 1.4%; HR 0.29, 95% CI 0.17 to 0.48) Secondary outcomes Significant decrease in major adverse cardiovascular and cerebrovascular events (4.3% vs. 5.9%; HR 0.71, 95% CI 0.59 to 0.85) Significant decrease in myocardial infarction (2.1% vs. 4.1%; HR 0.47, 95% CI 0.37 to 0.61) Borderline significant increase in death from any cause (2% vs. 1.5%; HR 1.36, 95% CI 1 to 1.85) Safety outcomes Significant differences in moderate or severe bleeding (2.5% vs. 1.6%, p = 0.001). Conclusion In patients who underwent a coronary stent procedure in which a drug-eluting stent was placed and who were treated with a thienopyridine drug (clopidogrel or prasugrel) and aspirin for 12 months, continued thienopyridine was superior to placebo with respect to stent thrombosis. Reference Mauri L, Kereiakes DJ, Yeh RW et al. Twelve or 30 months of dual antiplatelet therapy after drug- eluting stents. N Engl J Med. 2014 Dec 4;371(23):2155-66. Open reference URL https://web.pathway.md/studies/recPhyczxUeHQHD4Y 2/2