Abstract 14976: Impact of the Duration of Dual Antiplatelet Therapy in Patients with Peripheral Arterial Occlusive Disease After Percutaneous Transluminal Angioplasty on Clinical Outcomes

Abstract

Introduction: Limited data from clinical trials investigating dual antiplatelet therapy (DAPT) in patients with peripheral arterial occlusive disease (PAOD), suggested its potential for a reduction in cardiovascular events. However, the optimal duration of DAPT in patients with symptomatic PAOD after percutaneous transluminal angioplasty (PTA) has not been clearly established. The aim of this study was to determine the optimal duration of DAPT in patients with symptomatic PAOD after PTA. Hypothesis: Longer duration of DAPT is associated with better clinical outcomes in patients with symptomatic PAOD after PTA. Methods: From May 2011 to August 2012, 249 patients with 264 lesions treated with PTA were divided into two groups based on the duration of DAPT [aspirin plus clopidogrel, < 6-month DAPT (n= 120) vs. ≥ 6-month DAPT (n = 129)]. Propensity score-matching analysis was used to adjust for baseline characteristics between two groups. Results: The median follow-up duration was 22.0 ± 8.2 months. In Cox proportional hazard analysis, ≥ 6-month DAPT group was found to be associated with lower rates of MACE (myocardial infarction, stroke, death, and target lesion revascularization; hazard ration [HR]: 2.22; 95% confidence interval [CI]: 1.13-4.35, p = 0.021), and rehospitalization (unstable angina, transient ischemic attack, amputation, and other lesions PTA; HR: 2.29; 95% CI: 1.04-5.01, p = 0.039). Nevertheless, there was no significant association between duration of DAPT and bleeding. Conclusions: DAPT longer than 6 months was associated with lower rates of MACE and rehospitalization in patients with symptomatic PAOD after PTA.