Short-Term DAPT After Complex Percutaneous Coronary Intervention (PCI) With Third-Generation DES: A Post Hoc Analysis of the HOST-IDEA Trial
Authors' conclusion
In patients undergoing complex PCI with a third-generation drug-eluting stent, a 3- to 6-month duration of DAPT was associated with a reduced risk of bleeding without an increased risk of ischemic events compared with 12-month DAPT.
Study context
- Population
- Patients undergoing PCI with third-generation drug-eluting stents, analysed by complex vs noncomplex PCI (complex: ≥3 stents implanted, ≥3 lesions treated, bifurcation PCI with 2-stenting, total stent length ≥60 mm, left main PCI, or heavy calcification)624 underwent complex PCI · complex PCI 624
- Participants
- 1,992 patients
- Comparison
- 3 to 6 months of DAPT over 12 months after complex PCI
Primary result
As reported in the abstract
Target lesion failure:
- Cardiac death
- Target vessel myocardial infarction
- Clinically driven target lesion revascularization
3 to 6 months of DAPT vs 12 months of DAPTHazard ratio (95% CI)
Complex PCI group
0.818(0.403–1.659)
Noncomplex PCI group
1.282(0.506–3.249)
Further findings
- The complex PCI group had clinical features associated with high bleeding risk
Safety
| Outcome | Hazard ratio (95% CI) | |
|---|---|---|
| Major bleeding (BARC type 3 or 5) · 12 months3 to 6 months of DAPTvs 12 months of DAPTComplex PCI group | 0.269 (0.075–0.965) | |
| Major bleeding (BARC type 3 or 5) · 12 months3 to 6 months of DAPTvs 12 months of DAPTNoncomplex PCI group | 1.534 (0.627–3.754) | |
| 0.050.21520Hazard ratio (log scale) |
- Major bleeding (BARC type 3 or 5): significant interaction; P interaction =0.029
Original publication
Short-Term DAPT After Complex PCI With Third-Generation DES: A Post Hoc Analysis of the HOST-IDEA Trial. Circ Cardiovasc Interv. Published 31 March 2025. doi:10.
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