Dual antiplatelet therapy in patients with acute coronary syndrome treated at Hanoi Heart Hospital

Abstract

Objective: To assess the use of dual antiplatelet drugs and evaluate dual antiplatelet therapy (DAPT)-related adverse events in patients with acute coronary syndrome (ACS) managed at Hanoi Heart Hospital.

Subjects and Methods: A descriptive study with retrospective analysis was conducted on 392 patients diagnosed with ACS and treated at Hanoi Heart Hospital from June 2021 to July 2022. Data were collected from medical records and followed up for 12 months. Adverse events including bleeding, restenosis, and stroke were recorded and analyzed.

Results: All patients (100%) received DAPT during the initial phase, with the combination of Aspirin and Clopidogrel being the most commonly used, followed by Aspirin and Ticagrelor. At 1, 6, and 12 months, the DAPT usage rate varied; however, Aspirin and Clopidogrel consistently remained the most prescribed drugs. A diverse transition of medications was observed during the 12-month treatment period. The incidence of major bleeding was 1.28%, restenosis 3.82%, and stroke 9.18%. A high PRECISE-DAPT score was significantly associated with bleeding events (p = 0.035). Factors related to restenosis and stroke included elevated HbA1c, treatment de-escalation, and the number of stents.

Conclusion: The use of DAPT at Hanoi Heart Hospital relatively adheres to current clinical guidelines. However, treatment duration and strategies should be further optimized and individualized based on patients’ bleeding and thrombotic risk profiles.