A Prospective comparative study on analyzing the potency of mono antiplatelet therapy versus dual antiplatelet therapy in optimizing the recurrence of secondary vascular events

Abstract

Purpose: According to Global Burden of Diseases [GBD], India bares the highest burden of stroke. About 25 % of people who recover from their first stroke will have recurrence within five years. The use of antiplatelet therapy has been proven to be the best strategy available and several large studies support its use. However, the type of antiplatelet therapy used in the treatment and prevention of vascular diseases remains controversial. The present study aimed to assess the efficacy of mono and dual antiplatelet therapies in the secondary prevention of both cerebrovascular and cardiovascular events. Additionally, the study sought to provide insights into adverse drug reactions (ADRs), complications associated with antiplatelet medications, and the importance of medication adherence to enhance the quality of life in patients with these vascular events.

Methods: A prospective comparative study was conducted at Government General Hospital, Ananthapuramu, Andhra Pradesh, India. A total of 144 patients were recruited into the study.

Findings: In our study, 40 out of 105 DAPT patients were found to have recurrence of both cerebrovascular and cardiovascular events while 16 out of the 39 MAPT patients were found to have a similar recurrence. There was no statistically significant difference (p > 0.005) between DAPT and MAPT in secondary prevention of vascular events. Patient education and counseling helped in improving patient medication adherence from 17.3 % at baseline visit to 56.2 % during their second visit, which was measured by using medication adherence rating scale (MARS-10).

Implications: The findings of this study indicate that there was no statistically significant difference between DAPT and MAPT in secondary prevention of vascular events and both were considered to be equally effective in controlling incidence of recurrence of vascular events. Further research is needed to assess the long-term efficacy and safety of MAPT versus DAPT in various subgroups of patients with different vascular event profiles.

Keywords: Carotid artery stenosis; DAPT; Efficacy of MAPT; Myocardial infarction; Peripheral artery disease; Recurrence; Stroke; Vascular event.