Abbreviated or Standard Antiplatelet Therapy After Percutaneous Coronary Intervention (PCI) in Diabetic Patients at High Bleeding Risk
Authors' conclusion
MACCE and NACE rates were similar, and bleeding rates were lower with abbreviated APT in patients with or without diabetes. Therefore, diabetes status did not modify the treatment effects of abbreviated vs standard APT in HBR patients after biodegradable polymer sirolimus-eluting coronary stent implantation.
Study context
- Population
- High bleeding risk patients with and without diabetes mellitus (DM) after biodegradable polymer sirolimus-eluting coronary stent implantation1,538 [34%] with DM
- Participants
- 4,579 participants
- Comparison
- Abbreviated vs standard antiplatelet therapy, by DM status
- Abbreviatedn = 2,295
- Standardn = 2,284reference
- Primary endpoint
- Coprimary: NACE (all-cause death, MI, stroke, major bleeding), MACCE (all-cause death, MI, stroke), and major or clinically relevant nonmajor bleeding
- Follow-up
- 11 months
Methodological detailsprespecified analysis
- Prespecified analysis
Primary result
As reported in the abstract
Treatment effect by DM status (subgroup analysis)
- NACE similar with abbreviated vs standard antiplatelet therapy (APT) irrespective of DM status
- Pinteraction = 0.47
- MACCE similar with abbreviated vs standard APT irrespective of DM status
- Pinteraction = 0.59
- Major or clinically relevant nonmajor bleeding reduced with abbreviated APT irrespective of DM status
- Pinteraction = 0.55
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| MACCE, DMvs no DM | 1.28 (1.00–1.63) | |
| 0.512Hazard ratio (log scale) |
MACCE, DM vs no DM
- Similar net adverse or bleeding events with DM vs no DM
Original publication
Abbreviated or Standard Antiplatelet Therapy After PCI in Diabetic Patients at High Bleeding Risk. JACC Cardiovasc Interv. Published 25 November 2024. doi:10.
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