A new study suggests that heart patients who undergo percutaneous coronary interventions (PCIs) may not need to be on two blood thinners for a full 12 months post-procedure. These blood thinners are prescribed to prevent the formation of clots but come with a risk of bleeding events. The study found that participants who stopped taking aspirin after one month experienced a 55% reduction in bleeding issues with no increase in cardiac events while continuing a second blood thinner for the full 12 months. This new approach could significantly reduce bleeding complications while maintaining effective protection against clots.
When someone undergoes a PCI to address a heart blockage, doctors typically prescribe a pair of antiplatelet drugs for 12 months after the procedure. The study suggests that these blood thinners may be safely reduced after just one month without an increased risk of clots forming on the implanted hardware. The mix of post-procedure antiplatelet medications is known as dual antiplatelet therapy (DAPT), which typically includes aspirin and a stronger P2Y12 receptor inhibitor. The study focused on the use of ticagrelor, finding that it may be safe to stop taking aspirin after a month of dual blood thinners.
The study, published in The Lancet, involved 3,400 patients with acute coronary syndrome at centers in China, Italy, Pakistan, and the U.K. Participants had received PCI and were randomly assigned to different treatment groups after one month of stability post-procedure. Those in the ticagrelor-placebo group had a 55% reduction in bleeding events compared to those who remained on ticagrelor and aspirin for the full 12 months. Major cardiovascular events were statistically similar between the two groups, indicating that cutting aspirin after one month did not lead to an increase in adverse cardiovascular outcomes.
Cardiologists have been grappling with the balance between preventing ischemic events and managing bleeding risks associated with DAPT. The study’s results suggest that using ticagrelor alone between months 1 and 12 following PCI may provide similar rates of major adverse cardiac events with lower bleeding complications. This finding could lead to a shift in guideline recommendations by important advisory bodies like the American Heart Association and the American College of Cardiology. While the two-blood-thinner strategy has been in place for decades, the study’s results could prompt changes in post-PCI medication guidelines in the future.
Overall, the study’s results provide valuable insights into the management of blood thinners post-PCI, highlighting the potential for reducing bleeding risks while maintaining effective protection against clots. Moving forward, further research and data on this topic will be important to solidify the findings and potentially influence guideline revisions. The study’s findings offer promising implications for improving post-PCI care and outcomes for heart patients, demonstrating that a shift in medication strategies could lead to better overall patient outcomes in the long term.
