Dual antiplatelet therapy linked to better post-TCAR outcomes versus other drug regimens

Dual antiplatelet therapy (DAPT) has demonstrated improved clinical outcomes, including reduced in-hospital stroke and mortality risks, compared to other medication regimens in carotid artery disease patients who undergo stent placement via a transcarotid artery revascularisation (TCAR) procedure.

This is the key concluding message put forward by Hanaa Dakour-Aridi (Indiana University School of Medicine, Indianapolis, USA), S Keisin Wang (McGovern Medical School at UTHealth, Houston, USA) and colleagues in a recent Journal of Vascular Surgery (JVS) publication.

The authors queried all patients who underwent TCAR within the Vascular Quality Initiative (VQI) from September 2016 to June 2022 to determine the association between antiplatelet choices and outcomes. They did this against the backdrop of DAPT being the preferred medication regimen in post-TCAR patients, “despite a dearth of quality data”, in an effort to define the risks carried by different antiplatelet approaches.

“Patients maintained on DAPT were compared with those receiving alternative regimens consisting of single antiplatelet [therapy], anticoagulation, or a combination of the two,” Dakour-Aridi, Wang and colleagues note. “A 1:1 propensity-score match was performed with respect to baseline comorbidities, functional status, anatomic/physiologic risk, medications and intraoperative characteristics. In-hospital and one-year outcomes were compared