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Patients undergoing percutaneous coronary intervention (PCI) with severe coronary artery disease (CAD) and challenging lesion subsets require complex procedures and remain at increased risk of short and long-term adverse ischaemic events.
MASTER DAPT was an investigator‑initiated, randomised, open‑label trial conducted in patients at high bleeding risk after the implantation of an Ultimaster™/Ultimaster™ Tansei™ DES.
The trial compared abbreviated (1 month) dual antiplatelet therapy (DAPT) with non-abbreviated (3-12 months) DAPT.
The primary results showed that 1 month of DAPT was non-inferior to treatment continuation for at least 2 additional months for the occurrence of net adverse clinical events (NACE) and major adverse cardiac and cerebral events (MACCE) and reduced major or clinically relevant non-major bleeding (MCB) in the overall high bleeding risk population.
The aim of this prespecified subgroup analysis was to assess the consistency of the treatment effects of 1-month vs. a more prolonged DAPT duration based on PCI and patient (complex PCI and/or acute coronary syndrome (ACS)) complexity.
Complex PCI was defined as 3-vessels treated, ≥ 3 stents implanted, ≥3 lesions treated, bifurcation with two stents implanted, total stent length > 60 mm, or chronic total occlusion (CTO).
Source: Valgimigli et al. Eur Heart J. 2022
Patients randomized to an abbreviated or a non-abbreviated DAPT regimen were grouped according to the presence of complex PCI features and/or ACS.
In high bleeding risk patients undergoing PCI without recurrent ischemic events in the first 30 days after coronary intervention, PCI complexity and/or ACS does not justify a DAPT regimen longer than one month.
Link to the full publication: https://academic.oup.com/eurheartj/article/43/33/3100/6587125?login=true
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