Highlights of ESC Congress 2021: Master DAPT

<p>In a Hot Line session of 28th August, Professor Marco from Switzerland presented results from the investigator-initiated, open-label MASTER DAPT trial comparing an abbreviated vs. a standard duration of antiplatelet therapy after bioresorbable polymer-coated sirolimus-eluting stent implantation in patients with acute or chronic coronary syndrome who fulfilled one or more high bleeding-risk criteria.</p> <p>Following a mandatory 30-day DAPT run-in phase after percutaneous coronary intervention (PCI), eligible patients who were free from ischaemic and bleeding events were randomized 1:1 to receive abbreviated or standard DAPT.</p> <p>Abbreviated treatment comprised single antiplatelet therapy until study completion, except for patients receiving clinically indicated oral anticoagulation, who continued single antiplatelet therapy up to 6 months after PCI.</p> <p>Standard treatment comprised DAPT continuation for at least 5 additional months (6 months after PCI) or, for those receiving clinically indicated oral anticoagulation, for at least 2 additional months (3 months after PCI) and with continuation thereafter of single antiplatelet therapy.</p> <p>The three ranked coprimary outcomes were:</p> <p>1) net adverse clinical events (the composite of all-cause death, myocardial infarction [MI], stroke, and major or clinically relevant non-major bleeding);</p> <p>2) major adverse cardiac and cerebrovascular events (MACCE), the composite of all-cause death, MI, and stroke)</p> <p>3) major or clinically relevant non-major bleeding occurring between randomization and 335 days, defined as Bleeding Academic Research Consortium type 2, 3, or 5 bleeding.</p> <p>A total of 4,579 patients from 30 countries were randomized at a median of 34 days after PCI. The mean age was 76 years, 69.3% were men, 36.2% were receiving concomitant oral anticoagulation, and 48.3% underwent PCI for the acute coronary syndrome (ACS). There was a mean of 2.1 high bleeding-risk criteria per patient.</p> <p>The Abbreviated DAPT was found to be non-in