[Adverse events of dual antiplatelet therapy in patients over 75 years after acute myocardial infarction].
Source: PubMed, NCBI / U.S. National Library of Medicine
Acute coronary syndrome is one of the leading causes of morbidity and mortality in older adults. In patients aged ≥ 75 years, evidence regarding the safety of dual antiplatelet therapy (DAPT) is limited because these patients are frequently excluded from clinical trials and have a higher bleeding risk related to frailty and comorbidities. To evaluate the incidence of BARC 2, 3, or 5 bleeding events in patients aged ≥ 75 years with acute myocardial infarction according to DAPT duration (complete vs. abbreviated/interrupted). A retrospective observational cohort study was conducted in patients aged ≥ 75 years with acute coronary syndrome treated between January 2022 and December 2024. Patients were classified according to complete DAPT duration (12 months) or abbreviated/interrupted DAPT. Bleeding events were analyzed using the BARC classification, along with major adverse cardiovascular events. Relative risks (RR) with 95% confidence intervals (95% CI) were calculated, and multivariate logistic regression analysis was performed. Eighty patients were included, with a mean age of 80 ± 4 years. The overall incidence of bleeding events was 77.5%. No significant differences were found between complete and abbreviated/interrupted DAPT regarding bleeding events (RR: 1.07; 95% CI: 0.77-1.49; p = 0.668). In multivariate analysis, DAPT duration was not independently associated with bleeding events. Most bleeding events were of low severity. In this cohort of pa
Abstract
Acute coronary syndrome is one of the leading causes of morbidity and mortality in older adults. In patients aged ≥ 75 years, evidence regarding the safety of dual antiplatelet therapy (DAPT) is limited because these patients are frequently excluded from clinical trials and have a higher bleeding risk related to frailty and comorbidities. To evaluate the incidence of BARC 2, 3, or 5 bleeding events in patients aged ≥ 75 years with acute myocardial infarction according to DAPT duration (complete vs. abbreviated/interrupted). A retrospective observational cohort study was conducted in patients aged ≥ 75 years with acute coronary syndrome treated between January 2022 and December 2024. Patients were classified according to complete DAPT duration (12 months) or abbreviated/interrupted DAPT. Bleeding events were analyzed using the BARC classification, along with major adverse cardiovascular events. Relative risks (RR) with 95% confidence intervals (95% CI) were calculated, and multivariate logistic regression analysis was performed. Eighty patients were included, with a mean age of 80 ± 4 years. The overall incidence of bleeding events was 77.5%. No significant differences were found between complete and abbreviated/interrupted DAPT regarding bleeding events (RR: 1.07; 95% CI: 0.77-1.49; p = 0.668). In multivariate analysis, DAPT duration was not independently associated with bleeding events. Most bleeding events were of low severity. In this cohort of patients aged ≥ 75 years with acute coronary syndrome, bleeding events were highly frequent but generally mild, with no significant differences between complete and abbreviated/interrupted DAPT.