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Abstract

Percutaneous coronary intervention (PCI) requires dual antiplatelet therapy (DAPT). PCI-related DAPT cessation is prevalent. There are several reasons for DAPT cessation, each with clinical outcomes. A comprehensive literature review was performed across multiple databases, including PubMed, Scopus, Science Direct, and ProQuest for 2018 – 2023. The primary criteria for selected papers were the reported percentage of the study population classified as non-adherence. Secondary criteria include reasons for cessation or clinical outcomes of non-adherence. Quality assessment of the included studies was also evaluated. Eleven articles met the criteria and were analyzed. The extent of DAPT non-adherence was between 4.6% and 55.8%. All studies had no universal agreement regarding the definition of non-adherence and the reasons for DAPT cessation. The PARIS and the NARC studies are the biggest studies correlating the reasons for and the clinical outcomes of DAPT non-adherence. PARIS uses simpler categories for reasons of non-adherence, such as discontinuation, interruption, and disruption, while NARC uses risk profile change, events, surgery, unlisted, logistics, and trauma. Among those reasons, patient-driven non-adherence has the most significant negative impact on cardiac events in both studies. Furthermore, early DAPT discontinuation of at least 30 days had greater cardiac events. Adherence to DAPT after PCI is still challenging for patients undergoing PCI. Even though cardiac events may occur during adherence to DAPT treatment, the healthcare team must be aware of patient-owned decisions regarding non-adherence‎.

Keywords: DAPT, Reasons, Cessation, PCI, Cardiovascular

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