RT Journal Article
T1 Duration of antiplatelet therapy after complex percutaneous coronary intervention in patients at high bleeding risk: a MASTER DAPT trial sub-analysis.
A1 Valgimigli, Marco
A1 Smits, Pieter C
A1 Frigoli, Enrico
A1 Bongiovanni, Dario
A1 Tijssen, Jan
A1 Hovasse, Thomas
A1 Mafragi, Al
A1 Ruifrok, Willem Theodoor
A1 Karageorgiev, Dimitar
A1 Aminian, Adel
A1 Garducci, Stefano
A1 Merkely, Bela
A1 Routledge, Helen
A1 Ando, Kenji
A1 Diaz Fernandez, Josè Francisco
A1 Cuisset, Thomas
A1 Nesa Malik, Fazila Tun
A1 Halabi, Majdi
A1 Belle, Loic
A1 Din, Jehangir
A1 Beygui, Farzin
A1 Abhyankar, Atul
A1 Reczuch, Krzysztof
A1 Pedrazzini, Giovanni
A1 Heg, Dik
A1 Vranckx, Pascal
A1 MASTER DAPT Investigators, 
K1 Complex intervention
K1 Dual antiplatelet therapy
K1 High bleeding risk
K1 Percutaneous coronary intervention
AB To assess the effects of 1- or ≥3-month dual antiplatelet therapy (DAPT) in high bleeding risk (HBR) patients who received biodegradable-polymer sirolimus-eluting stents for complex percutaneous coronary intervention (PCI) and/or acute coronary syndrome (ACS). In the MASTER DAPT trial, 3383 patients underwent non-complex (abbreviated DAPT, n = 1707; standard DAPT, n = 1676) and 1196 complex (abbreviated DAPT, n = 588; standard DAPT, n = 608) PCI. Co-primary outcomes at 335 days were net adverse clinical events [NACE; composite of all-cause death, myocardial infarction, stroke, and bleeding academic research consortium (BARC) 3 or 5 bleeding events]; major adverse cardiac or cerebral events (MACCE; all-cause death, myocardial infarction, and stroke); and Types 2, 3, or 5 BARC bleeding. Net adverse clinical events and MACCE did not differ with abbreviated vs. standard DAPT among patients with complex [hazard ratio (HR): 1.03, 95% confidence interval (CI): 0.69-1.52, and HR: 1.24, 95% CI: 0.79-1.92, respectively] and non-complex PCI (HR: 0.90, 95% CI: 0.71-1.15, and HR: 0.91, 95% CI: 0.69-1.21; Pinteraction = 0.60 and 0.26, respectively). BARC 2, 3, or 5 was reduced with abbreviated DAPT in patients with and without complex PCI (HR: 0.64; 95% CI: 0.42-0.98, and HR: 0.70; 95% CI: 0.55-0.89; Pinteraction = 0.72). Among the 2816 patients with complex PCI and/or ACS, NACE and MACCE did not differ and BARC 2, 3, or 5 was lower with abbreviated DAPT. In HBR patients free from recurrent ischaemic events at 1 month, DAPT discontinuation was associated with similar NACE and MACCE and lower bleeding rates compared with standard DAPT, regardless of PCI or patient complexity. This trial is registered with ClinicalTrials.gov, number NCT03023020, and is closed to new participants, with follow-up completed.
YR 2022
FD 2022
LK http://hdl.handle.net/10668/19770
UL http://hdl.handle.net/10668/19770
LA en
DS RISalud
RD Apr 10, 2025