Table 2.
Age-specific data in main randomized studies about abbreviated DAPT strategy.
| Study | ACS Presentation (%) | PCI Rate (%) | Elderly Patients (%) | Groups | Follow-Up (m) |
Main Results |
|---|---|---|---|---|---|---|
| GLOBAL LEADERS [45,46] | STEMI (13.1%), NSTE-ACS (33.8%) | 100% | 75 y (16%) | 1 m ticagrelor + ASA -> 23 m ticagrelor vs. 12 m ticagrelor/ clopidogrel + ASA -> 12 m ASA |
24 | Short DAPT was not superior to standard strategy in the prevention of ischemic events, with no difference in major bleedings. These findings were not found to depend on age category. |
| TWILIGHT [47,48] | NSTE-ACS (64.8%) | 100% | ≥65 y (52%) | 3 m ticagrelor + ASA-> ticagrelor + placebo vs. 12 m ASA + ticagrelor |
12 | Short DAPT was associated with a lower incidence of clinically relevant bleeding, with no higher risk of ischemic events compared with standard DAPT. These findings were not found to depend on age category. |
| MASTER DAPT [49] | STEMI (11.7%), NSTE-ACS (36.5%) | 100% | ≥75 y (69%) | 1 m DAPT -> SAPT vs. 3–12 m DAPT -> SAPT |
12 | Short DAPT was non-inferior for preventing ischemic events and was superior for preventing major or clinically relevant non-major bleeding compared with standard DAPT. These findings were not found to depend on age category |
| STOPDAPT-2 ACS [50] | STEMI (56.2%), NSTEMI (43.8%) | 100% | ≥75 y (28.6%) | 1 m DAPT with clopidogrel/prasugrel -> 11 m clopidogrel vs. 1 m DAPT with clopidogrel/prasugrel-> 11 m DAPT with clopidogrel |
12 | Short DAPT did not achieve non-inferiority to 12 months of DAPT in terms of net clinical benefit, with a numerical increase in cardiovascular events. No treatment interaction by age was observed. |
| ULTIMATE DAPT [51] | STEMI (27.9%), NSTE-ACS (72.1%) | 100% | ≥65 y (42.1%) | 1 m ticagrelor + ASA -> ticagrelor vs. 12 m ticagrelor + ASA |
12 | Short DAPT resulted in a lower rate of clinically relevant bleeding and a similar rate of ischemic events compared with standard DAPT. Age analysis revealed no influence on bleeding events, but a significant benefit in reducing ischemic events was found in younger patients |
m = months, y = years.