1. TL-PAS: DAPT
Trial design: Patients undergoing PCI with Taxus Liberté PES, receiving prasugrel, without ischemic/bleeding complications, and compliant at 1 year, were randomized to further 18 months of dual antiplatelet therapy (DAPT) or placebo. They were followed for 18 months.
Results
(p < 0.001)
MACCE for DAPT vs. placebo: 3.7% vs. 8.8%, HR 0.41, 95% CI , p < 0.001
MI: 1.9% vs. 7.1%, p < 0.001; stent thrombosis: 0.2% vs. 2.9%, p < 0.001; all-cause mortality: 2.0% vs. 1.9%, p = 0.85
GUSTO moderate/severe bleeding: 2.4% vs. 1.7%, p = 0.23 %
Conclusions
Prolonged DAPT with aspirin and prasugrel for 30 months following index PCI with Taxus Liberté PES results in lower stent thrombosis and recurrent MIs compared with a 12-month duration of DAPT, with similar rates of bleeding and all-cause mortality
This is not a separate clinical trial, but a subset of the DAPT trial; this appears to be the subset with the clearest benefit
MACCE
DAPT
(n = 1,098)
Placebo
(n = 1,093)
Presented by Dr. Kirk Garratt at AHA 2014