Short-Term Dual Platelet Therapy Decreases Risk of Bleeding Events in Heart Stent Patients: Study

Abbreviated duration patients also saw fewer heart problems and strokes

A new study suggests treating patients with two blood thinners for shorter durations after a coronary stent implant may decrease the risk of severe bleeding or a cardiac event.

In findings published last week in the New England Journal of Medicine, researchers from Switzerland compared adverse outcome rates among patients treated with dual platelet therapy after having received a drug-eluting heart stent, to determine if shorter therapy durations increased or decreased health risks.

The study was funded by the European Cardiovascular Research Institute, and involved a team of researchers reviewing data on 4,434 patients who underwent implantation of a biodegradable-polymer sirolimus-eluting coronary stent, who took two different blood thinners to prevent blood clots following the procedure.

Researchers categorized the use of dual platelet therapy into either abbreviated use (one month) or standard use (three month) durations.

Patient incidences were assessed at 335 days following the first use of dual platelet therapy. The study looked at outcomes where patients suffered death from any cause, myocardial infarction, stroke, or major bleeding, and found 165 incidents from those in the abbreviated group, while 172 incidences were recorded from the standard therapy group.

A total of 133 patients (6.1%) in the abbreviated-therapy group and 132 patients (5.9%) in the standard-therapy group had a major adverse cardiac or cerebral event. Researchers also identified 148 patients (6.5%) from the abbreviated therapy group who suffered a major or clinically relevant nonmajor bleeding event, compared to 211 incidents (9.4%) of the standard therapy group.

The study’s findings suggest patients undergoing an abbreviated use of dual platelet medications, such as Aspirin and Plavix, were at lower risk of experiencing a major adverse cardiac or cerebral events and also had a lower risk of suffering from fatal bleeding events, when compared to the standard therapy group taking the medications for at least 3 months.

Over the last several years, several studies have questioned whether single drug therapy or dual drug therapy is more appropriate for individuals having undergone cardiac stent procedures. These procedures typically require patients to be placed on blood thinners for some time, to avoid blood clot complications like deep vein thrombosis or pulmonary embolism.

In findings published in the New England Journal of Medicine in October 2020, researchers revealed that patients given a combo of Plavix and aspirin faced nearly twice the rate of bleeding events than patients given aspirin alone.

In 2018, researchers from the University of Texas also warned that the drug combination could increase bleeding risks, but that study indicated they also lowered the risk of stroke when used together.

A study earlier that same year found that the combination of the two drugs could also increase the risk of heart attacks. In March 2018, South Korean researchers published a study in the medical journal The Lancet, which found little benefit in giving the two drugs to patients who had recently been implanted with a coronary stent.