Reducing Bleeding Risks After Stenting: Impact of Aspirin Discontinuation

In the field of cardiology, a groundbreaking study has unveiled a major breakthrough that could revolutionize the way heart attack patients are treated after undergoing coronary stenting procedures. The ULTIMATE-DAPT study, conducted by The Mount Sinai Hospital and Mount Sinai School of Medicine, has revealed that withdrawing aspirin one month after PCI (percutaneous coronary intervention) in high-risk heart patients and maintaining them on ticagrelor alone can significantly enhance outcomes and slash major bleeding incidents by over half in comparison to patients prescribed both aspirin and ticagrelor.

This study, which presented its results at the American College of Cardiology Scientific Sessions and was published in The Lancet, is the first to investigate high-risk ACS (acute coronary artery syndromes) patients who switch to ticagrelor with a placebo one month post-PCI, contrasting them with ACS patients continuing on ticagrelor with aspirin. The impact of this groundbreaking research is poised to reshape global care standards for heart patients.

Dr. Gregg W. Stone, the study co-chair, emphasized the pivotal findings of the ULTIMATE-DAPT trial, highlighting the substantial reduction in both major and minor bleeding events by more than 50% without an increase in adverse ischemic events. With an investigation encompassing 3,400 ACS patients at 58 medical facilities across four nations, the study's scope was extensive and comprehensive.

The pivotal aspect of the research was the randomization of patients, with half being transitioned to ticagrelor with a placebo after one month and the other half continuing on ticagrelor with aspirin. The outcomes were resoundingly clear - a 55% drop in overall bleeding incidents in the group withdrawing aspirin, without any detrimental impact on major adverse cardiac or cerebrovascular events. This data underpins the notion that discontinuing aspirin post-PCI in stable high-risk patients is a safe and advantageous practice that enhances outcomes.

Dr. Stone reinforces the importance of this study's results in challenging previous beliefs surrounding the necessity of prolonged dual antiplatelet therapy post-PCI, with contemporary stenting techniques minimizing the risk of ischemic complications. The quality of the research, particularly the utilization of a placebo, elucidates the significant benefits of withdrawing aspirin in patients post-PCI, ensuring unbiased and robust findings.

This groundbreaking study, funded by esteemed organizations and conducted under the aegis of The Mount Sinai Hospital, sets a new standard in cardiology care. Its implications will likely reverberate across medical guidelines and practices worldwide, potentially heralding a transformative approach in managing heart attack patients post-PCI.

Mount Sinai's unwavering commitment to advancing cardiology and heart surgery is demonstrated through initiatives like the ULTIMATE-DAPT study, reinforcing its position as a global leader in medical innovation and patient care.

Source: [EurekAlert](https://www.eurekalert.org/news-releases/1040292)