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The DAPT trial placed a great deal of emphasis on therapy compliance, as patients could only participate if they were 80% to 120% compliant and missed no more than 14 days of therapy in the first 12 months, according to Yekaterina Opsha, PharmD, BCPS-AQ Cardiology, a clinical specialist of cardiovascular medicine at Saint Barnabas Medical Center.
“[This] may sound like a lot, but in reality, I think our patients probably miss more days realistically than 14 in the first 12 months,” Dr. Opsha says.
Since the DAPT participants were only able to proceed if they were compliant and had no serious side effects, Dr. Opsha says it is difficult to say what would happen if they did experience adverse effects.
Physicians with patients on dual antiplatelet therapy will have to weigh the risks and benefits when considering discontinuation of therapy. Clear reasons to discontinue include the patient undergoing a major procedure or having a true bleed, as the risk of fatality is high in these 2 cases, Dr. Opsha notes.