Everolimus-Eluting Stent Plus Short DAPT Duration Better for Some Patients with ACS

NOVEMBER 07, 2017
An everolimus--eluting stent coupled with dual antiplatelet therapy (DAPT) may provide better outcomes for patients aged 75 years and older than a bare metal stent, according to results from the SENIOR trial, which were recently presented at the Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium.

The study, which was also published in The Lancet, assessed the use of Boston Scientific’s Synergy bioabsorbable polymer everolimus-eluting stent combined with shorter DAPT compared with the use of a bare-metal stent (BMS). The study included 1200 patients aged 75 years and older who underwent pre-specification of a tailored DAPT strategy: 1 month for patients with stable angina or silent ischemia, and 6 months for patients with acute coronary syndrome (including myocardial infarction).

After the intended duration of DAPT was recorded, 596 patients were assigned to Synergy and 604 were assigned to BMS.

The researchers noted that DAPT utilization was similar in both study arms, with approximately half of patients continuing DAPT beyond 1 month and only 20% of patients continuing beyond 6 months.

According to the findings, the primary endpoint of all-cause mortrality myocardial infarction, or ischemia-driven target lesion revascularization occurred in 68 patients in the Synergy group and 98 patients in the BMS group. Bleeding complications and stent thrombosis rates were low in both groups.

The researchers concluded that BMS should no longer be used as a strategy to reduce DAPT duration in these patients.

Reference

Varenne O, Cook S, Sideris G, et al. A randomized trial of a bioabsorbable polymer-based metallic DES vs. a BMS with short DAPT in patients with coronary artery disease older than 75 years: the SENIOR trial.  Presented at: Transcatheter Cardiovascular Therapeutics Scientific Symposium, October 30-November 2, 2017. Denver.

 

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