A major clinical trial published in the New England Journal of Medicine found that continuing dual antiplatelet therapy for a second year after coronary stenting reduced the risk of further heart events compared with aspirin alone, without raising the risk of serious bleeding.
The findings come from the DAPT-MVD trial, which focused on patients with multivessel coronary artery disease (a condition where more than one of the heart’s main arteries is markedly narrowed) who had remained stable for a full year after having one or more stents fitted. Stenting is a procedure where a small mesh tube is inserted to hold a narrowed artery open and restore blood flow.
Patients in the trial were already one year into standard dual antiplatelet therapy (DAPT) — a combination of aspirin and a second blood-thinning medicine — when the study compared continuing that dual regimen against dropping back to aspirin alone. Those who stayed on DAPT experienced fewer ischaemic events, meaning fewer instances of dangerously reduced blood flow to the heart, such as heart attacks.
The result that will interest clinicians most: the reduced risk came without a corresponding rise in bleeding complications, which has historically been the central concern about extending DAPT beyond the standard treatment window.
The NEJM, which published the full trial results and a research summary, is one of the world’s most widely cited peer-reviewed medical journals. The findings are likely to inform future guidance on how long patients with complex coronary disease should remain on combined blood-thinning treatment after stenting, though any change to individual prescribing decisions rests with a patient’s own cardiology team.
Anyone currently on antiplatelet therapy after a stenting procedure should not adjust or stop their medication without speaking to their GP or specialist first. Changes to blood-thinning regimens carry real risks in both directions.
Getting advice and help
- Do not stop or change antiplatelet medicines without first speaking to your GP or hospital cardiology team
- NHS 111 can provide guidance if you have concerns about your heart medication or experience new symptoms
- In an emergency — chest pain, breathlessness, or suspected heart attack — call 999 immediately
Source: @NEJM
Dual Blood-Thinning Therapy Cuts Heart Risk After Stenting, Trial Finds Quiz
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