Coronary disease & ACSMeta-analysis
1-Month or 3-Month Dual Antiplatelet Therapy (DAPT) in Women and Men at High Bleeding Risk Undergoing Percutaneous Coronary Intervention (PCI)
- Pooled analysis of 3 prospective studies (XIENCE Short DAPT Program)
- international
- sex-subgroup analysis
- propensity score stratification
Authors' conclusion
Among patients at HBR undergoing PCI with everolimus-eluting stents, 1- and 3-month DAPT was associated with similar risk for ischemic events irrespective of sex. In both women and men, 1-month DAPT resulted in less clinically relevant bleeding, although the bleeding risk difference was not significant after propensity score stratification.
Study context
- Population
- Patients at high bleeding risk undergoing PCI with fluoropolymer-based cobalt-chromium everolimus-eluting stents (XIENCE)1,154 (34.3%) women
- Participants
- 3,364 patients
- Comparison
- 1-month vs 3-month DAPT, then aspirin monotherapy, in women and men
- Outcome
- Death or MI
- Follow-up
- 1 year
Pooled result
As reported in the abstract
Death or MI, by sex
1-month DAPT vs 3-month DAPTAdjusted hazard ratio (95% CI)
women
0.86(0.54–1.36)
men
1.04(0.75–1.44)
Further pooled results
| Outcome | 1-month DAPT | 3-month DAPT | adjusted HR (95% CI) | |
|---|---|---|---|---|
| BARC types 2 to 5 bleeding, by sex (key secondary) · women · not significant after propensity score stratification | 7.1% | 11.2% | 0.66 (0.43–1.02) | |
| BARC types 2 to 5 bleeding, by sex (key secondary) · men · not significant after propensity score stratification | 8.5% | 9.7% | 0.78 (0.57–1.06) | |
| 0.512Adjusted hazard ratio (log scale) |
- Bleeding Academic Research Consortium (BARC) types 2 to 5 bleeding, by sex (key secondary): P for interaction = 0.378
Death or myocardial infarction (MI) and BARC 2–5 bleeding, women vs men · 1 year
- Death or MI similar in women and men
- 7.6% vs 8.1%
- BARC 2–5 bleeding similar in women and men
- 9.5% vs 9.2%
Original publication
1-Month or 3-Month DAPT in Women and Men at High Bleeding Risk Undergoing PCI. JACC Cardiovasc Interv. Published 19 February 2025. doi:10.1016/j.jcin.2025.01.424
Summarised from the published abstract; every number is checked against it