Triple antithrombotic therapy versus double antiplatelet therapy after percutaneous coronary intervention with stent implantation in patients requiring chronic oral anticoagulation: a meta-analysis.
Chin Med J (Engl)
; 126(13): 2536-42, 2013 Jul.
Article
em En
| MEDLINE
| ID: mdl-23823830
ABSTRACT
BACKGROUND:
Whether an addition of OAC to double antiplatelet therapy for patients with an indication of chronic oral anticoagulation undergoing PCI-S may improve clinical outcomes is still debated. This meta-analysis aimed to update and re-compare the benefits and risks of triple antithrombotic therapy (TT) with double anti-platelet therapy (DAPT) after in patients who requiring oral anticoagulation after percutaneous coronary interventions with stenting (PCI-s).METHODS:
Ten reports of observational retrospective or prospective studies were retrieved, including a total of 6296 patients, follow-up period ranging from 1 year to 2 years.RESULTS:
Baseline characteristics were similar in both groups. The main finding of this study is the overall incidence of major adverse cardiovascular events (MACE), myocardial infarction (MI) and stent thrombosis was comparable between two groups. Patients with TT was associated with significant reduction in ischemic stroke (OR 0.27; 95%CI 0.13 - 0.57; P = 0.0006) as compared to DAPT. We reaffirmed triple therapy significantly increased the risk of major bleeding (OR 1.47; 95%CI 1.22 - 1.78; P < 0.0001) and minor bleeding (OR 1.55; 95%CI 1.07 - 2.24; P = 0.02).CONCLUSIONS:
Triple therapy is more efficacious in reducing the occurrence of ischemic stroke in PCI-s patients with an indication of chronic oral anticoagulation (OAC), compared with DAPT. However, it significantly increased major and minor risk of bleeding. It is imperative that further prospective randomized controlled trials are required to defne the best therapeutic strategy for patients with an indication of chronic OAC undergoing PCI-s.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Inibidores da Agregação Plaquetária
/
Stents
/
Fibrinolíticos
/
Intervenção Coronária Percutânea
/
Anticoagulantes
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Chin Med J (Engl)
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
China