A new analysis of the global RESOLUTE clinical trial has shown that interrupting dual antiplatelet therapy after 30 days following the implantation of a Resolute drug-eluting stent (Medtronic) caused no increase in rates of stent thrombosis at one year. The analysis was presented by Sigmund Silber, director of the Heart Centre at the Isar in Munich, Germany, at TCT.
The global RESOLUTE clinical programme enrolled 5,130 patients who received a Resolute drug-eluting stent in nearly 250 sites in 32 countries across Europe, Asia, the Pacific Rim, the Middle East, Africa, Latin America and North America.
“This analysis adds provocative new insight to ongoing discussions about the minimal duration of dual antiplatelet therapy required to safeguard patients with the latest generation drug-eluting stents,” said Silber. “For those patients with a Resolute stent who interrupted dual antiplatelet therapy after just one month following the implant procedure—which in this cohort was not always for medical indications—there appears to be no additional risk of stent thrombosis through one year of follow-up.”
“On such an important topic, it bears restating that clinicians should consider all of the available evidence on dual antiplatelet therapy and, based on their medical judgment, make the most appropriate decisions for each of their patients. As always, patient safety is of paramount importance,” said Silber.
The new analysis of dual antiplatelet therapy interruption included data on nearly 5,000 patients for whom the relevant information was available and used the Academic Research Consortium (ARC) definitions of stent thrombosis.
The analysis was performed to examine the one-year rates of stent thrombosis in patients whose dual antiplatelet therapy was interrupted after one month and three months following their implant procedure. More than two-thirds of the patients in the analysis permanently discontinued dual antiplatelet therapy:
- 907 patients interrupted or discontinued their dual antiplatelet therapy after one month. None of these patients experienced ARC definite/probable stent thrombosis through one year of follow-up.
- 816 patients interrupted or discontinued their dual antiplatelet therapy after threemonths. Similarly, none of these patients experienced ARC definite/probable stent thrombosis through one year of follow-up.