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July 26, 2026Open Access

Baseline Anemia and Short Dual Antiplatelet Therapy in High Bleeding Risk Patients Undergoing Percutaneous Coronary Intervention.

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Why the study?

Does 1-month DAPT reduce bleeding without increasing ischemic risk compared to 3-month DAPT in high bleeding risk patients with baseline anemia undergoing PCI?

Population

3,364 high bleeding risk patients undergoing percutaneous coronary intervention with cobalt-chromium…

Comparison

1-month dual antiplatelet therapy (DAPT) vs 3-month dual antiplatelet therapy (DAPT)

Design

Cohort

Follow-up

1 year

Key result

In anemic high bleeding risk patients undergoing PCI, 1-month DAPT had similar ischemic outcomes (HR 0.94; 95% CI 0.59-1.52) but lower major bleeding (HR 0.49) compared to 3-month DAPT.

Authors

FMFrancesca Maria Di MuroSSSamantha SartoriDADominick J Angiolillo

Discussion

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Overview

Anemia marks higher ischemic and bleeding risk after short DAPT in HBR PCI patients; extends XIENCE program data to this subgroup.

Key Points

  • This analysis aims to determine the impact of dual antiplatelet therapy duration on ischemic and bleeding outcomes in high bleeding risk patients with baseline anemia.
  • Included 3,364 high bleeding risk patients from three trials in the XIENCE Short DAPT Program
  • Defined anemia as hemoglobin <11 g/dL and assessed outcomes using propensity score stratification
  • Primary endpoint was all-cause death or myocardial infarction; secondary endpoints included BARC 2-5 and 3-5 bleeding.
  • Anemic patients had higher rates of ischemic and bleeding events at 1 year compared to non-anemic patients.
  • 1-month DAPT in anemic patients had a major bleeding incidence of 6.1% vs 11.1% for 3-month DAPT (adjHR 0.49, 95% CI 0.24-1.00; p=0.050) with similar ischemic outcomes.
  • In non-anemic patients, outcomes were similar regardless of DAPT duration.

Study Design

Type

Cohort (n=3,364)

Multicenter

Yes

Structured PICO

Does 1-month DAPT reduce bleeding without increasing ischemic risk compared to 3-month DAPT in high bleeding risk patients with baseline anemia undergoing PCI?

P
Population
3,364 high bleeding risk patients undergoing percutaneous coronary intervention with cobalt-chromium everolimus-eluting stents, followed for 1 year.
E
Exposure
1-month dual antiplatelet therapy (DAPT)
C
Comparator
3-month dual antiplatelet therapy (DAPT)
O
Outcome
Composite of all-cause death or myocardial infarction at 1 yearcomposite

Main Result

Hazard Ratio: 0.94 (95% CI 0.59–1.52)

Absolute Event Rate: 15.7% vs 16.3%

p-value: p=0.807

In high bleeding risk patients with baseline anemia undergoing PCI, abbreviating DAPT to 1 month reduces major bleeding without increasing ischemic risk compared to 3 months of DAPT.

Limitations

  • Results should be interpreted with caution and confirmed in randomized studies
  • Non-randomized comparison (propensity score stratified) requiring confirmation in randomized studies

Cite This Study

Muro et al. (2026) conducted a cohort in High bleeding risk undergoing percutaneous coronary intervention (n=3,364). 1-month dual antiplatelet therapy vs. 3-month dual antiplatelet therapy was evaluated on all-cause death or myocardial infarction (adjHR 0.94, 95% CI 0.59-1.52, p=0.807). In anemic high bleeding risk patients undergoing PCI, 1-month DAPT had similar ischemic outcomes (HR 0.94; 95% CI 0.59-1.52) but lower major bleeding (HR 0.49) compared to 3-month DAPT.

synapsesocial.com/papers/6a65a7e0d3aea3239cd7876chttps://doi.org/10.48620/99769
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Short- Versus Standard-Duration Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis2026
  2. 2Shorter vs. Standard Duration of Dual Antiplatelet Therapy in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis2025
  3. 3One‐Year Outcomes of Short‐Term Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention With Drug‐Eluting Stents: A Meta‐Analysis of Randomized Clinical Trials2025
  4. 4Personalized Antithrombotic Therapy After Percutaneous Coronary Intervention: A Systematic Review of Risk‐Stratified Approaches2026
  5. 5Comparative Evaluation of Prolonged Dual Antiplatelet Therapy versus Conventional Regimens on Prognosis in Patients with High Residual Inflammatory Risk: Results from a Prospective Observational Study2026 · 1 citations