Dual anti platelet therapy duration where to draw the line

Dual Anti-Platelet Therapy Duration Where to draw the line? Marvin H. Eng MD FSCAI FACC Assistant Professor of Medicine University of Texas Health Sciences Center San Antonio, TX Disclosures • No relevant disclosures [...]... Tailored therapy (no covered) has not proven to decrease thrombotic events – Optimal duration and premature discontinuation still unknown • Understanding of late biological events – Neoathetherosclerosis – Delayed stent healing – Understanding the body’s propensity to have thrombotic events • Fertile research for biomarkers and stent design – Bioabsorbable stents – Abluminal coating – Rapid endothelialization...Cumulative Events (%) DAPT ASA and Thienopyridine Stopping Time from Antiplatelet Discontinuation to Late ST (Days) Eisenberg MJ et al Circulation 2009;119: 1634-1642 DAPT Duration Interruption vs Disruption Mehran R et al Lancet 2013;382:1742-22 ADAPT-DES Incidence of ST according to ACS STEMI NSTEMI UA (no MI) No ACS P-value Overall 1.98% 1.59% 1.13% 0.80% 0.006... Valgimigli, M et al ACC 2014, Washington D.C E-ZES OCT by 2 week interval Nishinari, M et al CCI 2013l82:E871-8 R-ZES Pooled Analysis ST . Dual Anti- Platelet Therapy Duration Where to draw the line? Marvin H. Eng MD FSCAI FACC Assistant Professor of Medicine University of Texas Health Sciences Center San Antonio,. and Thienopyridine Stopping Eisenberg MJ et al. Circulation 2009;119: 1634-1642. Cumulative Events (%) Time from Antiplatelet Discontinuation to Late ST (Days) DAPT Duration Interruption. Trial Stent N DAPT Duration ST Rate (%) SIRIUS SES 1058 3 months 0.4% TAXUS IV PES 1314 6 months 0.6% Moses JW et al. NEJM 2003;349:1315-23. Stone GW et al. Circulation2004;109:1942-7.