Personalized or Standard Duration of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention: PARTHENOPE Randomized Trial.
Year: 2025
Type: article
Abstract: Background Dual antiplatelet therapy (DAPT) is recommended for patients undergoing percutaneous coronary intervention (PCI), although its optimal duration remains uncertain.Objectives We performed a randomized trial comparing a personalized duration of DAPT, based on a risk score, for 3-, 6-, or 24-months with a standard duration of DAPT for 12 months after PCI.Methods We randomly assigned 2,107 patients undergoing PCI to receive either a personalized or a standard DAPT. The primary end point was a net adverse clinical end point (NACE) at 24-months, defined as the composite of all-cause death, myocardial infarction, stroke, urgent target-vessel revascularization, or type 2, 3, or 5 bleeding according to the Bleeding Academic Research Consortium (BARC) criteria. The trial was registered in ClinicalTrials.gov (NCT04135989) RESULTS: At 24-months, NACE occurred in 196 of 1,055 patients (18.6%) in the personalized DAPT group and in 232 of 1,052 patients (22.2%) in the standard DAPT group (difference, 3.54 percentage points, 95% confidence interval [CI], -6.99 to -0.99; P=0.040). This difference was mainly related to decreased rates of myocardial infarction (difference, -2.29 percentage points, 95% CI, -4.43 to -0.14) and urgent target-vessel revascularization (difference, -1.30 percentage points, 95% CI, -2.55 to -0.05). Bleeding occurred at similar rates between the two groups (difference, -0.41 percentage points; 95% confidence interval [CI], -2.92 to 2.10).Conclusions In patients undergoing PCI, a personalized DAPT duration from 3 to 24 months based on a clinical risk score led to a lowered risk of net adverse clinical events than standard care consisting of 12 months of DAPT.
DOI: 10.48620/91086
Authors: Piccolo, Raffaele, Calabrò, Paolo, Carrara, Greta, Simonetti, Fiorenzo, Varricchio, Attilio, Attisano, Tiziana, Napolitano, Giovanni, De Simone, Ciro, Carpinella, Gerardo, Stabile, Eugenio, Cirillo, Plinio, Di Serafino, Luigi, Caiazzo, Gianluca, Tesorio, Tullio, Boccalatte, Marco, Tuccillo, Bernardino, Avvedimento, Marisa, Leone, Attilio, Galasso, Gennaro, Cesaro, Arturo, Perrotta, Rocco, Niglio, Tullio, Castiello, Domenico Simone, Molaro, Maddalena Immobile, Bardi, Luca, Spinelli, Alessandra, Cristiano, Stefano, Bellino, Michele, Leonardi, Sergio, Biscaglia, Simone, Costa, Francesco, Cassese, Salvatore, McFadden, Eugene, Heg, Dik, Stefanini, Giulio G, Franzone, Anna, Capodanno, Davide, Esposito, Giovanni
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7079497144
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