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<title>Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention: Clinical and Economic Impact of Standard Versus Extended Duration - NCBI Bookshelf</title>
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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="author" content="George A. Wells, Jesse Elliott, Shannon Kelly, Zemin Bai, Michel Boucher, Becky Skidmore, Derek So, Suzanne Laplante, Karen Lee" /><meta name="citation_title" content="Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention: Clinical and Economic Impact of Standard Versus Extended Duration" /><meta name="citation_publisher" content="Canadian Agency for Drugs and Technologies in Health" /><meta name="citation_date" content="2019/03" /><meta name="citation_author" content="George A. Wells" /><meta name="citation_author" content="Jesse Elliott" /><meta name="citation_author" content="Shannon Kelly" /><meta name="citation_author" content="Zemin Bai" /><meta name="citation_author" content="Michel Boucher" /><meta name="citation_author" content="Becky Skidmore" /><meta name="citation_author" content="Derek So" /><meta name="citation_author" content="Suzanne Laplante" /><meta name="citation_author" content="Karen Lee" /><meta name="citation_pmid" content="31246386" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK542937/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention: Clinical and Economic Impact of Standard Versus Extended Duration" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="Canadian Agency for Drugs and Technologies in Health" /><meta name="DC.Contributor" content="George A. Wells" /><meta name="DC.Contributor" content="Jesse Elliott" /><meta name="DC.Contributor" content="Shannon Kelly" /><meta name="DC.Contributor" content="Zemin Bai" /><meta name="DC.Contributor" content="Michel Boucher" /><meta name="DC.Contributor" content="Becky Skidmore" /><meta name="DC.Contributor" content="Derek So" /><meta name="DC.Contributor" content="Suzanne Laplante" /><meta name="DC.Contributor" content="Karen Lee" /><meta name="DC.Date" content="2019/03" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK542937/" /><meta name="description" content="Dual antiplatelet therapy (DAPT) — the combination of a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) together with ASA — is routinely given following percutaneous coronary intervention (PCI) with stenting, with the aim of preventing stent thrombosis and other major adverse cardiac and cerebrovascular events (MACCEs). Current guidelines recommend tailoring the length of DAPT, depending on individual patient characteristics. Prescribing DAPT for six to 12 months is generally accepted as being standard practice following PCI with stenting. However, given the risk of developing stent thrombosis and de novo recurrent ischemic events, evidence assessing the impact of extending the duration of DAPT beyond 12 months has been increasing over the last few years. It would appear that some benefits may be derived from such practice, although clinicians also need to consider the associated bleeding risk. It is therefore important for clinicians to identify those patients most likely to benefit from extended DAPT, as well as rule out those who may derive more harm than good from using such an approach. Also, in some jurisdictions, reimbursement of P2Y12 inhibitors after coronary stenting may be limited to 12 months, particularly reimbursement of prasugrel and ticagrelor. On the other hand, where restrictions have been lifted — in particular for clopidogrel — it may be important to ensure that extended therapy will result in optimal outcomes for patients after PCI and not result in more harm. Accordingly, given the current uncertainty about the benefits and harms of extended DAPT beyond one year, further elucidation of the available evidence, including the assessment of both the clinical and economic impact, is required to inform health care decision-makers, policy-makers, clinicians, and patients." /><meta name="og:title" content="Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention: Clinical and Economic Impact of Standard Versus Extended Duration" /><meta name="og:type" content="book" /><meta name="og:description" content="Dual antiplatelet therapy (DAPT) — the combination of a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) together with ASA — is routinely given following percutaneous coronary intervention (PCI) with stenting, with the aim of preventing stent thrombosis and other major adverse cardiac and cerebrovascular events (MACCEs). Current guidelines recommend tailoring the length of DAPT, depending on individual patient characteristics. Prescribing DAPT for six to 12 months is generally accepted as being standard practice following PCI with stenting. However, given the risk of developing stent thrombosis and de novo recurrent ischemic events, evidence assessing the impact of extending the duration of DAPT beyond 12 months has been increasing over the last few years. It would appear that some benefits may be derived from such practice, although clinicians also need to consider the associated bleeding risk. It is therefore important for clinicians to identify those patients most likely to benefit from extended DAPT, as well as rule out those who may derive more harm than good from using such an approach. Also, in some jurisdictions, reimbursement of P2Y12 inhibitors after coronary stenting may be limited to 12 months, particularly reimbursement of prasugrel and ticagrelor. On the other hand, where restrictions have been lifted — in particular for clopidogrel — it may be important to ensure that extended therapy will result in optimal outcomes for patients after PCI and not result in more harm. Accordingly, given the current uncertainty about the benefits and harms of extended DAPT beyond one year, further elucidation of the available evidence, including the assessment of both the clinical and economic impact, is required to inform health care decision-makers, policy-makers, clinicians, and patients." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK542937/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-op0533-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/op0533/toc/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK542937/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="cadthopcollect" />
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="http://www.cadth.ca/" title="Canadian Agency for Drugs and Technologies in Health" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-op0533-lrg.png" alt="Cover of Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention: Clinical and Economic Impact of Standard Versus Extended Duration" /></a><div class="icnblk_cntnt"><h1 id="_NBK542937_"><span itemprop="name">Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention: Clinical and Economic Impact of Standard Versus Extended Duration</span></h1><p><i>CADTH Optimal Use Report, No. 9.2b</i></p><p class="contrib-group"><span itemprop="author">George A. Wells</span>, <span itemprop="author">Jesse Elliott</span>, <span itemprop="author">Shannon Kelly</span>, <span itemprop="author">Zemin Bai</span>, <span itemprop="author">Michel Boucher</span>, <span itemprop="author">Becky Skidmore</span>, <span itemprop="author">Derek So</span>, <span itemprop="author">Suzanne Laplante</span>, and <span itemprop="author">Karen Lee</span>.</p><div class="half_rhythm">Ottawa (ON): <a href="http://www.cadth.ca/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">Canadian Agency for Drugs and Technologies in Health</span></a>; <span itemprop="datePublished">2019 Mar</span>.</div><div class="half_rhythm"><ul class="inline_list"><li><span class="label"><a data-jig="ncbidialog" href="#_ncbi_dlg_cpyrght_NBK542937" data-jigconfig="modal:true">Copyright and
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Permissions</a></span></li></ul></div><div id="_ncbi_dlg_cpyrght_NBK542937" style="display:none" title="Copyright and Permissions"><div><div>Copyright © 2019 Canadian Agency for Drugs and Technologies in Health.</div><div class="half_rhythm"><div>Except where otherwise noted, this work is distributed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International licence (CC BY-NC-ND), a copy of which is available at <a href="http://creativecommons.org/licenses/by-nc-nd/4.0/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=uri">http://creativecommons.org/licenses/by-nc-nd/4.0/</a></div><div>The copyright and other intellectual property rights in this document are owned by CADTH and its licensors. These rights are protected by the Canadian <i>Copyright Act</i> and other national and international laws and agreements. Users are permitted to make copies of this document for non-commercial purposes only, provided it is not modified when reproduced and appropriate credit is given to CADTH and its licensors.</div></div></div></div><div class="bk_noprnt"><form method="get" action="/books/n/op0533/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><p>Dual antiplatelet therapy (<a class="def" href="/books/n/op0533/abb/def-item/abb_DL1_DI5/">DAPT</a>) — the combination of a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) together with ASA — is routinely given following percutaneous coronary intervention (<a class="def" href="/books/n/op0533/abb/def-item/abb_DL1_DI17/">PCI</a>) with stenting, with the aim of preventing stent thrombosis and other major adverse cardiac and cerebrovascular events (MACCEs). Current guidelines recommend tailoring the length of DAPT, depending on individual patient characteristics. Prescribing DAPT for six to 12 months is generally accepted as being standard practice following PCI with stenting. However, given the risk of developing stent thrombosis and de novo recurrent ischemic events, evidence assessing the impact of extending the duration of DAPT beyond 12 months has been increasing over the last few years. It would appear that some benefits may be derived from such practice, although clinicians also need to consider the associated bleeding risk. It is therefore important for clinicians to identify those patients most likely to benefit from extended DAPT, as well as rule out those who may derive more harm than good from using such an approach. Also, in some jurisdictions, reimbursement of P2Y12 inhibitors after coronary stenting may be limited to 12 months, particularly reimbursement of prasugrel and ticagrelor. On the other hand, where restrictions have been lifted — in particular for clopidogrel — it may be important to ensure that extended therapy will result in optimal outcomes for patients after PCI and not result in more harm. Accordingly, given the current uncertainty about the benefits and harms of extended DAPT beyond one year, further elucidation of the available evidence, including the assessment of both the clinical and economic impact, is required to inform health care decision-makers, policy-makers, clinicians, and patients.</p></div><div><h2>Contents</h2><div class="bktoc_all_cntnr top align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div><ul id="toc_tllNBK542937_toc_fm-ch1" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK542937_toc_fm-ch1"><a class="toc-item" href="/books/n/op0533/fm-ch1/">Expert Consultant</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_fm-ch2"><a class="toc-item" href="/books/n/op0533/fm-ch2/">Authorship</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_fm_ack"><a class="toc-item" href="/books/n/op0533/fm.ack/">Acknowledgements</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_abb"><a class="toc-item" href="/books/n/op0533/abb/">Abbreviations</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch1"><a class="toc-item" href="/books/n/op0533/ch1/">Executive Summary</a><ul id="toc_lst_NBK542937_toc_ch1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch1_s1"><a class="toc-item" href="/books/n/op0533/ch1/#ch1.s1">Rationale and Policy Issues</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch1_s2"><a class="toc-item" href="/books/n/op0533/ch1/#ch1.s2">Clinical Review</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch1_s3"><a class="toc-item" href="/books/n/op0533/ch1/#ch1.s3">Economic Analysis</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch1_s4"><a class="toc-item" href="/books/n/op0533/ch1/#ch1.s4">Discussion</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch1_s5"><a class="toc-item" href="/books/n/op0533/ch1/#ch1.s5">Conclusion and Implications for Decision-Making</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch2"><a class="toc-item" href="/books/n/op0533/ch2/">Rationale and Policy Issues</a><ul id="toc_lst_NBK542937_toc_ch2" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch2_s1"><a class="toc-item" href="/books/n/op0533/ch2/#ch2.s1">Background and Rationale</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch2_s2"><a class="toc-item" href="/books/n/op0533/ch2/#ch2.s2">Patient Group Input Summary</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch2_s3"><a class="toc-item" href="/books/n/op0533/ch2/#ch2.s3">Objectives</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch3"><a class="toc-item" href="/books/n/op0533/ch3/">Policy Questions</a><ul id="toc_lst_NBK542937_toc_ch3" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch3_s1"><a class="toc-item" href="/books/n/op0533/ch3/#ch3.s1">Policy Question 1</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch3_s2"><a class="toc-item" href="/books/n/op0533/ch3/#ch3.s2">Policy Question 2</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch4"><a class="toc-item" href="/books/n/op0533/ch4/">Research Questions</a><ul id="toc_lst_NBK542937_toc_ch4" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch4_s1"><a class="toc-item" href="/books/n/op0533/ch4/#ch4.s1">Research Question 1</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch4_s2"><a class="toc-item" href="/books/n/op0533/ch4/#ch4.s2">Research Question 2</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch4_s3"><a class="toc-item" href="/books/n/op0533/ch4/#ch4.s3">Research Question 3</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch4_s4"><a class="toc-item" href="/books/n/op0533/ch4/#ch4.s4">Research Question 4</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch5"><a class="toc-item" href="/books/n/op0533/ch5/">Methods — Clinical</a><ul id="toc_lst_NBK542937_toc_ch5" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch5_s1"><a class="toc-item" href="/books/n/op0533/ch5/#ch5.s1">Clinical Evaluation</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch6"><a class="toc-item" href="/books/n/op0533/ch6/">Results of Clinical Evaluation</a><ul id="toc_lst_NBK542937_toc_ch6" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch6_s1"><a class="toc-item" href="/books/n/op0533/ch6/#ch6.s1">Selection of Primary Studies</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch6_s2"><a class="toc-item" href="/books/n/op0533/ch6/#ch6.s2">Study Characteristics</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch6_s3"><a class="toc-item" href="/books/n/op0533/ch6/#ch6.s3">Risk of Bias</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch6_s4"><a class="toc-item" href="/books/n/op0533/ch6/#ch6.s4">Data Synthesis</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch7"><a class="toc-item" href="/books/n/op0533/ch7/">Methods — Economics</a><ul id="toc_lst_NBK542937_toc_ch7" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch7_s1"><a class="toc-item" href="/books/n/op0533/ch7/#ch7.s1">Research Question 2</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch7_s2"><a class="toc-item" href="/books/n/op0533/ch7/#ch7.s2">Research Question 4</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch7_s3"><a class="toc-item" href="/books/n/op0533/ch7/#ch7.s3">Review of Published Economic Evaluations</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch7_s4"><a class="toc-item" href="/books/n/op0533/ch7/#ch7.s4">Economic Evaluation</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch7_s5"><a class="toc-item" href="/books/n/op0533/ch7/#ch7.s5">Assumptions Within the Economic Model</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch7_s6"><a class="toc-item" href="/books/n/op0533/ch7/#ch7.s6">Scenario and Sensitivity Analyses</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch7_s7"><a class="toc-item" href="/books/n/op0533/ch7/#ch7.s7">Model Validation</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch8"><a class="toc-item" href="/books/n/op0533/ch8/">Results of Economic Evaluation</a><ul id="toc_lst_NBK542937_toc_ch8" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch8_s1"><a class="toc-item" href="/books/n/op0533/ch8/#ch8.s1">Primary Analysis</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch8_s2"><a class="toc-item" href="/books/n/op0533/ch8/#ch8.s2">Exploratory Analyses</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch8_s3"><a class="toc-item" href="/books/n/op0533/ch8/#ch8.s3">Sensitivity Analyses</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch8_s4"><a class="toc-item" href="/books/n/op0533/ch8/#ch8.s4">Validation</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch9"><a class="toc-item" href="/books/n/op0533/ch9/">Discussion</a><ul id="toc_lst_NBK542937_toc_ch9" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch9_s1"><a class="toc-item" href="/books/n/op0533/ch9/#ch9.s1">Summary of Clinical Evidence</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch9_s2"><a class="toc-item" href="/books/n/op0533/ch9/#ch9.s2">Interpretation of the Clinical Results</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch9_s3"><a class="toc-item" href="/books/n/op0533/ch9/#ch9.s3">Strengths and Limitations of the Clinical Systematic Review</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch9_s4"><a class="toc-item" href="/books/n/op0533/ch9/#ch9.s4">Interpretation of the Economic Evaluation</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_ch10"><a class="toc-item" href="/books/n/op0533/ch10/">Conclusions and Implications for Decision- or Policy-Making</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_rl_r1"><a class="toc-item" href="/books/n/op0533/rl.r1/">References</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app1"><a class="toc-item" href="/books/n/op0533/app1/">Appendix 1. Literature Search Strategy</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app2"><a class="toc-item" href="/books/n/op0533/app2/">Appendix 2. List of Included Records</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app3"><a class="toc-item" href="/books/n/op0533/app3/">Appendix 3. List of Studies Excluded at Full-Text Review</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app4"><a class="toc-item" href="/books/n/op0533/app4/">Appendix 4. Characteristics of Included Studies</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app5"><a class="toc-item" href="/books/n/op0533/app5/">Appendix 5. Baseline Participant Characteristics</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app6"><a class="toc-item" href="/books/n/op0533/app6/">Appendix 6. Baseline Participant Characteristics (Continued)</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app7"><a class="toc-item" href="/books/n/op0533/app7/">Appendix 7. Characteristics: Type of Implanted Drug-Eluting Stents Among Randomized Participants</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app8"><a class="toc-item" href="/books/n/op0533/app8/">Appendix 8. Inclusion and Exclusion Criteria for Included Studies</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app9"><a class="toc-item" href="/books/n/op0533/app9/">Appendix 9. Study-Level Risk of Bias Assessment</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app10"><a class="toc-item" href="/books/n/op0533/app10/">Appendix 10. Bleeding Classification System Definitions</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app11"><a class="toc-item" href="/books/n/op0533/app11/">Appendix 11. Definitions Used in Randomized Controlled Trials</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app12"><a class="toc-item" href="/books/n/op0533/app12/">Appendix 12. Use of Ticagrelor in the Pegasus-Timi 54 Trial</a></li><li class="half_rhythm" id="toc_itm_NBK542937_toc_app13"><a class="toc-item" href="/books/n/op0533/app13/">Appendix 13. Pharmacoeconomics</a></li></ul><div class="bktoc_all_cntnr align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div></div><div class="pmc_boxed-text-box fm-sec whole_rhythm"><h3>About the Series</h3><div class="half_rhythm"><div>CADTH Optimal Use Report</div></div><div class="half_rhythm"><div>ISSN: 1927-0127</div></div></div><div><p>Dr. Wells declared having received funding from Abbott within five years preceding this project. Funding was received for educational activities.</p><p>Dr. Welsh declared having received funding from the following companies within five years preceding this project: Astra Zeneca, Bayer, BMS/Pfizer, Boehringer Ingelheim. Funding was received for advisory work, as well as educational and research activities.</p></div><div><b>Funding:</b> CADTH receives funding from Canada’s federal, provincial, and territorial governments, with the exception of Quebec.</div><div><h4 class="inline">Suggested citation:</h4><p><i>Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention: Clinical and Economic Impact of Standard Versus Extended Duration</i>. Ottawa: CADTH; 2019 Mar. (CADTH Optimal Use Report; vol. 9, no. 2b).</p></div><div><p><b>Disclaimer:</b> The information in this document is intended to help Canadian health care decision-makers, health care professionals, health systems leaders, and policy-makers make well-informed decisions and thereby improve the quality of health care services. While patients and others may access this document, the document is made available for informational purposes only and no representations or warranties are made with respect to its fitness for any particular purpose. The information in this document should not be used as a substitute for professional medical advice or as a substitute for the application of clinical judgment in respect of the care of a particular patient or other professional judgment in any decision-making process. The Canadian Agency for Drugs and Technologies in Health (CADTH) does not endorse any information, drugs, therapies, treatments, products, processes, or services.</p><p>While care has been taken to ensure that the information prepared by CADTH in this document is accurate, complete, and up-to-date as at the applicable date the material was first published by CADTH, CADTH does not make any guarantees to that effect. CADTH does not guarantee and is not responsible for the quality, currency, propriety, accuracy, or reasonableness of any statements, information, or conclusions contained in any third-party materials used in preparing this document. The views and opinions of third parties published in this document do not necessarily state or reflect those of CADTH.</p><p>CADTH is not responsible for any errors, omissions, injury, loss, or damage arising from or relating to the use (or misuse) of any information, statements, or conclusions contained in or implied by the contents of this document or any of the source materials.</p><p>This document may contain links to third-party websites. CADTH does not have control over the content of such sites. Use of third-party sites is governed by the third-party website owners’ own terms and conditions set out for such sites. CADTH does not make any guarantee with respect to any information contained on such third-party sites and CADTH is not responsible for any injury, loss, or damage suffered as a result of using such third-party sites. CADTH has no responsibility for the collection, use, and disclosure of personal information by third-party sites.</p><p>Subject to the aforementioned limitations, the views expressed herein are those of CADTH and do not necessarily represent the views of Canada’s federal, provincial, or territorial governments or any third party supplier of information.</p><p>This document is prepared and intended for use in the context of the Canadian health care system. The use of this document outside of Canada is done so at the user’s own risk.</p><p>This disclaimer and any questions or matters of any nature arising from or relating to the content or use (or misuse) of this document will be governed by and interpreted in accordance with the laws of the Province of Ontario and the laws of Canada applicable therein, and all proceedings shall be subject to the exclusive jurisdiction of the courts of the Province of Ontario, Canada.</p></div><div><p>PROSPERO REGISTRATION NUMBER: CRD42018082587</p></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK542937/?report=reader">PubReader</a></li><li><a href="/books/NBK542937/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK542937" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK542937" style="display:none" title="Cite this Page"><div class="bk_tt">Wells GA, Elliott J, Kelly S, et al. Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention: Clinical and Economic Impact of Standard Versus Extended Duration [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019 Mar. 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