Ariza, AlbertMateus Porta, GemmaFormiga, FrancescGarcía Blas, SergioBonanad, ClaraNuñez-Gil, IvánVergara-Uzcategui, Carlos EduardoDíez Villanueva, PabloBañeras; JordiBadia Molins, ClaraAboal, JaimeCarreras-Mora, JoséGabaldón-Pérez, AnaParada Barcia, Jose AntonioMartínez-Sellés, ManuelComín Colet, JosepRaposeiras-Roubín, Sergio2024-04-192024-04-192023Ariza-Solé A, Mateus-Porta G, Formiga F, Garcia-Blas S, Bonanad C, Núñez-Gil I, et al. Extended use of dual antiplatelet therapy among older adults with acute coronary syndromes and associated variables: a cohort study. Thromb J. 2023 Mar 21;21(1):32. DOI: 10.1186/s12959-023-00476-51477-9560http://hdl.handle.net/10230/59839Background Current guidelines recommend extending the use of dual antiplatelet therapy (DAPT) beyond 1 year in patients with an acute coronary syndrome (ACS) and a high risk of ischaemia and low risk of bleeding. No data exist about the implementation of this strategy in older adults from routine clinical practice. Methods We conducted a Spanish multicentre, retrospective, observational registry-based study that included patients with ACS but no thrombotic or bleeding events during the first year of DAPT after discharge and no indication for oral anticoagulants. High bleeding risk was defined according to the Academic Research Consortium definition. We assessed the proportion of cases of extended DAPT among patients 65 ≥ years that went beyond 1 year after hospitalisation for ACS and the variables associated with the strategy. Results We found that 48.1% (928/1,928) of patients were aged ≥ 65 years. DAPT was continued beyond 1 year in 32.1% (298/928) of patients ≥ 65; which was a similar proportion as with their younger counterparts. There was no significant correlation between a high bleeding risk and DAPT duration. Contrastingly, there was a strong correlation between the extent of coronary disease and DAPT duration (p < 0.001). Other variables associated with extended DAPT were a higher left ventricle ejection fraction, a history of heart failure and a prior stent thrombosis. Conclusion There was no correlation between age and extended use of DAPT beyond 1 year in older patients with ACS. DAPT was extended in about one-third of patients ≥ 65 years. The severity of the coronary disease, prior heart failure, left ventricle ejection fraction and prior stent thrombosis all correlated with extended DAPT.application/pdfeng© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.info:eu-repo/semantics/articlehttp://dx.doi.org/10.1186/s12959-023-00476-5ElderlyAcute coronary syndromesDual antiplatelet therapyBleeding riskinfo:eu-repo/semantics/openAccess