Individualised antiplatelet therapy prescribing after percutaneous coronary intervention

Abstract

Antithrombotic therapy prescribing after percutaneous coronary intervention (PCI) is challenging and requires consideration of bleeding and ischaemic risk. The aims were to: assess bleeding risk, optimise antithrombotic therapy prescribing, and evaluate outcomes, in a cohort of patients undergoing PCI. Patients (N=200) undergoing PCI and candidates for dual antiplatelet therapy (DAPT) were prospectively recruited by convenience sampling after ethics approval. A data collection sheet was developed, validated, and completed via patient interview and hospital records. The PRECISE-DAPT score, presently not routinely used in local practice, was applied in all patients to calculate bleeding risk (≥25 high, 18-24 moderate, 0.05) between short-term and long-term DAPT duration for ischaemic outcomes and mortality. No cases of major bleeding were documented. For minor bleeding (melaena, haematuria or gingival bleeding), a significant difference (p0.05) in minor bleeding between DAPT durations was observed. Pharmacist-led bleeding risk evaluation in patients undergoing PCI was useful in supporting cardiologists in the personalisation and optimisation of antithrombotic therapy. Outcomes in the patient cohort studied were comparable between short- and long-term DAPT duration.