Thrombotic vs. Bleeding Events of Interruption of Dual Antiplatelet Therapy within 12 Months among Patients with Stent-Driven High Ischemic Risk Definition following PCI

Table 1

30-month ischemic and bleeding outcomes by DAPT interruption status.

	DAPT interruption ≤12 months (n = 1122)	DAPT maintenance >12 months (n = 2809)	Multivariable adjusted		Propensity score matching		IPTW adjusted		Unadjusted
			HR (95% CI)	value	HR (95% CI)	value	HR (95% CI)	value	HR (95% CI)	value
Major adverse cardiac and cerebrovascular events^a	44 (3.9)	62 (2.2)	1.840 (1.247–2.716)	0.002	2.049 (1.236–3.399)	0.005	1.843 (1.250–2.717)	0.002	1.963 (1.334–2.887)	0.001
All-cause death	20 (1.8)	21 (0.7)	2.510 (1.353–4.653)	0.003	2.679 (1.177–6.096)	0.019	2.513 (1.357–4.653)	0.003	2.505 (1.356–4.627)	0.003
Cardiac death	16 (1.4)	9 (0.3)	4.597 (2.011–10.509)	<0.001	5.711 (1.660–19.646)	0.006	4.786 (2.098–10.914)	<0.001	4.685 (2.067–10.622)	<0.001
Myocardial infarction	15 (1.3)	15 (0.5)	2.486 (1.209–5.113)	0.013	3.133 (1.137–8.633)	0.027	2.636 (1.279–5.435)	0.009	2.636 (1.287–5.399)	0.008
Stent thrombosis (definite/probable)	9 (0.8)	8 (0.3)	2.979 (1.141–7.783)	0.026	3.204 (0.865–11.869)	0.081	3.175 (1.227–8.213)	0.017	3.031 (1.166–7.879)	0.023
Stroke	19 (1.7)	38 (1.4)	1.275 (0.730–2.224)	0.393	1.349 (0.684–2.662)	0.387	1.317 (0.761–2.280)	0.326	1.329 (0.766–2.309)	0.312
Clinically relevant bleeding^b	11 (1.0)	32 (1.1)	0.922 (0.462–1.840)	0.818	0.796 (0.365–1.740)	0.568	0.864 (0.430–1.736)	0.681	0.926 (0.466–1.841)	0.827
Net adverse clinical events^c	55 (4.9)	91 (3.2)	1.581 (1.128–2.216)	0.008	1.639 (1.075–2.499)	0.022	1.554 (1.110–2.177)	0.010	1.613 (1.153–2.257)	0.005

Values are number of events (Kaplan–Meier estimated event rates), unless otherwise indicated. Adjusted variables included age, sex, body mass index, current smoking, hypertension, diabetes mellitus, left ventricular ejection fraction, peripheral artery disease, prior coronary artery bypass grafting, prior myocardial infarction, prior PCI, prior major bleeding, acute coronary syndrome presentation, transradial approach, use of intravascular ultrasound, drug-eluting stent type, and total stent length. ^aMajor adverse cardiac and cerebrovascular events included the composite of all-cause mortality, myocardial infarction, or stroke; ^bclinically relevant bleeding was defined as BARC type 2, 3, or 5 bleeding; ^cnet adverse clinical events included the composite of all-cause mortality, myocardial infarction, stroke, or clinically relevant bleeding. CI, confidence interval; CABG, coronary artery bypass grafting; DAPT, dual antiplatelet therapy; HR, hazard ratio; PCI, percutaneous coronary intervention.