A major clinical trial found that patients who continued dual antiplatelet therapy for a second year after coronary stenting had fewer heart attacks and strokes than those who switched to aspirin alone.
The findings come from the DAPT-MVD trial, which looked at people with multivessel coronary artery disease (a condition where more than one of the heart’s main arteries is narrowed or blocked) who had remained stable for a year after having a stent fitted. The trial found that patients who continued on dual antiplatelet therapy (DAPT) — a combination of two blood-thinning medicines, typically aspirin plus a second drug — for a further year showed a lower risk of ischaemic events, meaning heart attacks, strokes, or other complications caused by restricted blood flow.
Crucially for patients and clinicians weighing up the risks, the trial found no increase in bleeding among those who stayed on the two-drug regimen. Bleeding risk is one of the main reasons doctors consider stopping the second blood thinner after the first year, so this finding adds weight to the case for extending treatment in this group.
The results apply specifically to patients who were in stable condition at the one-year mark after stenting. They do not necessarily apply to all heart patients, and treatment decisions should always be made with a GP or cardiologist based on individual circumstances.
Anyone with questions about their own heart medication should speak to their GP or call NHS 111 for guidance. Do not stop or change prescribed blood-thinning medication without medical advice. In an emergency, call 999.
Key information
- NHS 111 — for non-emergency medical questions about your medication or heart condition
- Your GP or cardiologist — speak to them before making any changes to antiplatelet therapy
- 999 — for chest pain, sudden breathlessness, or any suspected heart emergency
Source: @NEJM