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Finding decline
Aortic stenosis was significantly associated with increased all-cause mortality in MI patients treated with DAPT, with approximately 2-fold increased risk in Sweden and 1.5-fold in Denmark.
Effect sizeHR 1.76
CI95% CI 1.26-2.47
Follow-up1 year
ComparatorMI patients without aortic stenosis treated with DAPT
Effect summarydecline; HR 1.76; CI: 95% CI 1.26-2.47
Effect modifiers[{"modifier": "bleeding event", "interaction_p": "", "direction": "amplifies", "stratum_details": "Post-bleeding mortality in AS patients: 73.5 (Sweden) and 34.2 (Denmark) per 100 person-years vs 46.8 and 20.4 in non-AS patients. Bleeding events amplify the already-elevated mortality in AS patients.", "plain_language": "If an aortic stenosis patient on blood thinners has a bleeding event after a heart attack, their risk of dying goes up dramatically \u2014 much more than for patients without aortic stenosis.", "annotation_notes": "No formal interaction test reported, but the absolute mortality rates after bleeding were substantially higher in AS patients."}, {"modifier": "revascularization (PCI subgroup)", "interaction_p": "", "direction": "null", "stratum_details": "PCI subgroup: Sweden HR 2.35 (95% CI 1.54-3.59), Denmark HR 2.17 (95% CI 1.71-2.75). Mortality risk persisted in PCI subgroup.", "plain_language": "Even among patients who had coronary stenting, those with aortic stenosis still had over twice the mortality risk.", "annotation_notes": "Sensitivity analysis. The mortality risk from AS is independent of revascularization status."}]

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Source

PMC6717510
Outcomes associated with dual antiplatelet therapy after myocardial infarction in patients with aortic stenosis
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