Safety and Efficacy of Single vs Dual Antiplatelets Therapy After Atrial Septal Defect Device Closure

  • Chandra Mani Adhikari Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Dipanker Prajapati Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Amrit Bogati Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Kiran Prasad Acharya Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Anjana Acharya Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Roshani Shahi Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Swikirty Shrestha Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Vijay Ghimire Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Kavindra Thapa Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • Kunjang Sherpa Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Abstract

Background: Atrial septal defect device closure has become a standard procedure. Antiplatelet therapy is used to prevent thrombus formation in the device. There is no clear recommendation about the antiplatelets drugs. This study aims to evaluate the safety and efficacy of Aspirin vs (Aspirin +Clopidogrel) after device closure.
Methods: A cross-sectional study was conducted among all consecutive adult patients (?18 years) who underwent atrial septal defect device closure from May 2019 to April 2020 and meet the inclusion criteria were included. After successful ASD device closure patients were treated with ASA or combination of ASA and Clopidogrel for six months on physician discretion. Patients were followed up for six months to observe for Transient ischemic attack, Stroke, thrombus in the device, myocardial infarction, major bleeding, minor bleeding and increases in headache episodes compared to baseline.
Results: This study consisted of 130 patients: 65 in the Aspirin Group, and 65 patients in Aspirin and Clopidogrel group. There was no Transient ischemic attack, Stroke, Myocardial infarction, thrombus, major bleeding in both groups. There was no significant difference between two groups in ecchymosis; Aspirin group 4(6.1%) vs. aspirin and Clopidogrel group 3(4.6%) [Difference, 1.54% {95, % CI, -1.45%to 4.53%}]; P=0.648. There was no significant difference in increase in headache episodes compared to baseline for six months after the device closure in Aspirin Group 3(4.6%) VS Aspirin and Clopidogrel group 2 (3.0%) group [difference, 1.54% {95% CI, -1.45%to 4.53%}]; P=0.648.
Conclusions: Our study suggests that single antiplatelet therapy with Aspirin is as safe and effective as aspirin and clopidogrel after device closure.
Keywords: Atrial septal defect; ASD device closure; clopidogrel

Published
2021-09-06
How to Cite
AdhikariC. M., PrajapatiD., BogatiA., AcharyaK. P., AcharyaA., ShahiR., ShresthaS., GhimireV., ThapaK., & SherpaK. (2021). Safety and Efficacy of Single vs Dual Antiplatelets Therapy After Atrial Septal Defect Device Closure. Journal of Nepal Health Research Council, 19(2), 295-299. https://doi.org/10.33314/jnhrc.v19i2.3477