The recommended length of dual anti-platelet therapy (DAPT) has been the topic of debate in the medical industry. Some experts believe that DAPT should be shorter than 12 months while others suggest that extended DAPT can lower the risk of stent thrombosis and myocardial infarction.
Researchers suggest that patients who were given anti-clotting drugs for 30 months post a heart stent placement were found to have reduced the risks of blood clots and heart attacks when compared to patients who were given the drugs for 12 months of less.
Laura Mauri lead author and principal investigator of the study suggests that DAPT is essential for patients getting coronary stents to prevent blood clots in the stents. The latest study indicates that blood clotting in the stents can be prevented for longer time when medications are taken for over 12 months.
Mauri explains that a stent is a thin wire-mesh tube that is inserted into a patient's blocked coronary artery. The stent holds the artery open and the blood flow is also restored. Risks post stent placements are infrequent but it may cause blood clotting in another blood vessel or in the stent.
The study found that participants taking aspirin along with another anti-clotting medicine such as prasugrel or clopidogrel for 30 months (instead of 12) post stent placement witnessed better medical results. These patients were significantly less likely to get in-stent thrombosis or clotting. These patients reduced the risk of getting a heart attack by 50 percent.
"The benefits were larger than we had expected," says Mauri.
Mauri highlights that the overall benefits of longer medication were very steady in all patient types they study. She also suggests that DAPT study is the first that compares the time duration of treatments and their benefits to the patients. Previously, it was not clear if the extended treatment reduced the risk of in-stent thrombosis or averted strokes and heart attacks.
Even though the study reveals the benefits of extended treatment, healthcare professional should still consider health risks on an individual patient basis when prescribing dual anti-clotting therapy. Mauri suggests that the latest trial did not include patients with a major bleeding history before stent placement or within a year from the treatment.
Mauri also revealed that per European guidelines, patients should get 6 to 12 months of treatment after stent placement. The U.S. recommends the treatment for 12 months.
The study has been published in the journal Lancet.
