Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 Oct;121(11):e20240202.
doi: 10.36660/abc.20240202.

Fixed-Dose Antiplatelet Dual Combination in Patients with Coronary Artery Disease in Turkish Population: DAPT-TR

[Article in Portuguese, English]
Ahmet Öz  1 , Kenan Toprak  2 , Ertan Aydin  3 , İbrahim Saraç  4 , Mustafa Doğduş  5 , Selçuk Opan  6 , Mustafa Yenerçağ  7 , Mustafa Begenc Tascanov  2 , Ömer Kümet  8 , Miraç Karaağaç  9 , Murat Özmen  4 , Bektaş Murat  10 , Ömer Kertmen  11 , Özkan Bekler  12 , Sinan İnci  13 , Mustafa Ahmet Huyut  14 , Ahmet Özderya  15 , Fahri Er  16 , Mustafa Duran  17 , İsa Ardahanlı  18 , Mehmet Memduh Baş  19 , Tuncay Güzel  20 , Gökhan Ceyhun  21 , İbrahim Halil Özdemir  22 , Mehmet Burak Özen  22 , Ramazan Gündüz  22 , Aslan Erdoğan  23 , İlyas Çetin  23 , Veysel Özgür Barış  24 , Çağrı Yayla  25 , Medeni Karaduman  26 , Lütfü Aşkın  27 , Lütfü Bekar  28 , Okan Tanrıverdi  29 , Eyüp Özkan  23 , Emrah Yeşil  30 , Serhat Çalışkan  31 , Zülfiye Kuzu  32 , Berat Uğuz  33 , Ferit Böyük  34 , Ayşegül Ülgen Kunak  35 , Selda Murat  36 , Serkan Asil  37 , Özkan Kayhan  38 , Emrah Erdoğan  26 , Ramazan Duz  26 , Fahrettin Katkat  39 , Tuba Ekin  40 , Ersin İbişoğlu  23 , Bilge Nazar Ateş  41 , Burak Ayça  39 , Asım Oktay Ergene  42 , Mehdi Zoghi  43
Affiliations
Observational Study

Fixed-Dose Antiplatelet Dual Combination in Patients with Coronary Artery Disease in Turkish Population: DAPT-TR

[Article in Portuguese, English]
Ahmet Öz et al. Arq Bras Cardiol. 2024 Oct.

Abstract
in English, Portuguese

Background: Dual antiplatelet therapy (DAPT) is the treatment of choice for patients with acute and chronic coronary syndromes as it reduces mortality and prevents recurrent thrombotic complications. The assessment of both ischaemic burden and bleeding risk is crucial in deciding which DAPT to choose and how long it should be continued.

Objectives: The aim of our study was to perform prospective clinical follow-up of patients receiving fixed-dose combination therapy (ASA 75 mg + clopidogrel 75 mg). Our study is a multicentric, cross-sectional, observational, cohort study.

Methods: A total of 1500 patients who were started on fixed-dose combination DAPT for acute or chronic coronary syndrome were included in the study. Primary endpoints were hospitalization for any reason, hospitalization for cardiovascular cause, acute myocardial infarction, stent thrombosis, target vessel revascularization and bleeding; the secondary endpoints were death for any reason or cardiovascular cause and stroke. The significance level adopted in the statistical analysis was 5%.

Results: Median age was 63 years; 78.5% of the patients were receiving DAPT treatment for acute coronary syndrome. The rates of hospitalization for cardiovascular reasons, acute myocardial infartion, stent thrombosis and target-vessel revascularization were 7.9%, 2.3%, 1.3% and 4.2%, respectively. While the rate of BARC type 1 bleeding was 3.3%, the rate of BARC type 5, 3, or 2 bleeding was 0.6%. The secondary endpoints which were death from any cause, cardiovascular death and stroke were 0.5%, 0.3% and 0.3%, respectively. Conclusion: Our study shows that fixed-dose combination therapy is effective and safe in appropriately selected patients with acute or chronic coronary syndromes.

Fundamento: A Terapia Antiplaquetária Dupla (DAPT, do inglês dual antiplatelet therapy) é o tratamento de escolha para pacientes com síndromes coronarianas agudas e crônicas, uma vez que ela reduz mortalidade e previne complicações trombóticas recorrentes. A avaliação da carga isquêmica e do risco de sangramento é crucial na escolha da DAPT e de sua duração.

Objetivos: O objetivo de nosso estudo foi conduzir um acompanhamento clínico prospectivo de pacientes recebendo terapia combinada (AAS 75mg + clopidogrel 75 mg). Nosso estudo é um estudo multicêntrico, transversal, observacional, do tipo coorte.

Métodos: Foram incluídos 1500 pacientes que iniciaram DAPT combinada para o tratamento de síndrome coronariana aguda ou síndrome coronariana crônica. Os desfechos primários foram internação hospitalar por qualquer motivo, internação por causa cardiovascular, infarto agudo do miocárdio, trombose de stent, revascularização de vaso alvo e sangramento; os desfechos secundários foram morte por qualquer razão ou por causa cardiovascular e acidente vascular cerebral. O nível de significância adotado na análise estatística foi 5%.

Resultados: A idade mediana foi 63 anos; 78,5% dos pacientes estavam recebendo DAPT por síndrome coronariana aguda. As taxas de internação por causas cardiovasculares, de infarto agudo do miocárdio, de trombose de stent e de revascularização de vaso alvo foram 7,9%, 2,3%, 1,3% e 4,2%, respectivamente. Enquanto a taxa de sangramento segundo a escala BARC tipo 1 foi de 3,3%, a taxa de sangramento BARC tipo 5, 3, ou 2 foi 0,6%. As taxas dos desfechos secundários morte por qualquer razão, morte por causa cardiovascular e acidente vascular cerebral foram 0,5%, 0,3% e 0,3%, respectivamente.

Conclusão: Nosso estudo mostrou que a DAPT em regime combinado de doses fixas de AAS e clopidogrel é eficaz e seguro em pacientes com síndrome coronariana aguda ou crônica adequadamente selecionados.

Plain language summary

Figura Central : Terapia Antiplaquetária Dupla Combinada em Pacientes com Doença Arterial Coronariana em uma População na Turquia: DAPT-TR.

PubMed Disclaimer

Conflict of interest statement

Potencial conflito de interesse: Não há conflito com o presente artigo

Figures

Central Illustration:
Central Illustration:. Fixed-Dose Antiplatelet Dual Combination in Patients with Coronary Artery Disease in Turkish Population: DAPT-TR
Figura Central
Figura Central. : Terapia Antiplaquetária Dupla Combinada em Pacientes com Doença Arterial Coronariana em uma População na Turquia: DAPT-TR
See this image and copyright information in PMC

References

    1. Murray CJ, Lopez AD. Global Mortality, Disability, and the Contribution of Risk Factors: Global Burden of Disease Study. Lancet. 1997;349(9063):1436–1442. doi: 10.1016/S0140-6736(96)07495-8. - DOI - PubMed
    1. Valgimigli M, Bueno H, Byrne RA, Collet JP, Costa F, Jeppsson A, et al. 2017 ESC Focused Update on Dual Antiplatelet Therapy in Coronary Artery Disease Developed in Collaboration with EACTS: The Task Force for Dual Antiplatelet Therapy in Coronary Artery Disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-thoracic Surgery (EACTS) Eur Heart J. 2018;39(3):213–260. doi: 10.1093/eurheartj/ehx419. - DOI - PubMed
    1. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting with ST-segment Elevation: The Task Force for the Management of Acute Myocardial Infarction in Patients Presenting with ST-segment Elevation of the European Society of Cardiology (ESC) Eur Heart J. 2018;39(2):119–177. doi: 10.1093/eurheartj/ehx393. - DOI - PubMed
    1. Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-segment Elevation. Eur Heart J. 2021;42(14):1289–1367. doi: 10.1093/eurheartj/ehaa575. - DOI - PubMed
    1. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. 2019 ESC Guidelines for the Diagnosis and Management of Chronic Coronary Syndromes. Eur Heart J. 2020;41(3):407–477. doi: 10.1093/eurheartj/ehz425. - DOI - PubMed

Publication types

MeSH terms