RE-DUAL PCI: Benefit of Dabigatran Dual Therapy in Subgroup Analysis

The benefit of dabigatran dual therapy vs. warfarin triple therapy in patients with atrial fibrillation (AFib) undergoing percutaneous coronary intervention (PCI) was consistent across subgroups, according to an analysis from the RE-DUAL PCI trial presented Nov. 14 at AHA 2017 in Anaheim, CA.

Jonas Oldgren, MD, PhD, et al., looked at RE-DUAL PCI trial patients with acute coronary syndrome (ACS) and non-ACS at index event, those receiving drug-eluting stents (DES) vs. bare metal stents and patients treated with ticagrelor or clopidogrel. The dabigatran dual therapy regimen used dabigatran and a P2Y12 platelet antagonist, while warfarin triple therapy combined warfarin, aspirin and a P2Y12 platelet antagonist. 

Results showed that the index indication for PCI was an ACS in 50 percent of the patients. DES alone were used in 83 percent of the patients, and were similar in patients with ACS and non-ACS. In addition, the majority of patients received clopidogrel; 12 percent of the patients received ticagrelor either as part of dabigatran dual therapy or warfarin triple therapy. Patients who received ticagrelor more often had ACS as the index event, were oral anticoagulation naïve, and had DAPT clinical complexity factors; and ticagrelor was associated with higher risk of bleeding than clopidogrel.

Further, the researchers explain that there "were no significant interactions in any of the presented outcomes for any of the presented subgroups," and that the benefit of dabigatran dual therapy vs. warfarin triple therapy in patients with AFib who underwent PCI was consistent with the main trial results.

Keywords: AHA17, AHA Annual Scientific Sessions, Fibrinolytic Agents, Atrial Fibrillation, Percutaneous Coronary Intervention, Cardiovascular Diseases

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