Short-term (1-3 months) versus standard (12 months) dual antiplatelet therapy following new-generation drug-eluting stent implantation: A meta-analysis of randomized controlled trials.
Medicine (Baltimore)
; 103(22): e38071, 2024 May 31.
Article
in En
| MEDLINE
| ID: mdl-39259115
ABSTRACT
BACKGROUND:
Patients undergoing percutaneous coronary intervention mainly receive antiplatelet therapy. However, limited data are available regarding the optimal dual antiplatelet therapy (DAPT) following the implantation of new-generation drug-eluting stent (DES).OBJECTIVE:
This study aimed to compare the clinical outcomes of short-term (1-3 months) DAPT and standard (12 months) DAPT after the implantation of a new-generation of DES.METHODS:
We systematically searched PubMed, The Cochrane Library Database, Embase for trials that compared short-term (1-3 months) and standard DAPT after the implantation of next-generation DES were retrieved from all published studies in English until December 31, 2021. The primary endpoint was major bleeding. The secondary endpoints included all-cause mortality, cardiac death, myocardial infarction, stroke, stent thrombosis, and all bleeding.RESULTS:
This study included a total of 7 randomized controlled trials, comprising 28,344 subjects. Regarding primary endpoints, short-term DAPT exhibited a significantly lower incidence of major bleeding compared with standard DAPT [relative risk (RR) 0.66, 95% confidence interval (CI) (0.54, 0.81), Pâ <â .0001]. For secondary endpoints, there were significant differences between short-term and standard DAPT in all bleeding [RR 0.59, 95% CI (0.50, 0.69), Pâ <â .00001]. However, no significant differences were identified in all-cause mortality [RR 0.96, 95% CI (0.77, 1.18), Pâ =â .27], myocardial infarction [RR 0.98, 95% CI (0.82, 1.18), Pâ =â .86], cardiac death [RR 0.83, 95% CI (0.63, 1.10), Pâ =â .20], stroke [RR 1.08, 95% CI (0.79, 1.47), Pâ =â .63], cerebrovascular [RR 1.08, 95% CI (0.79, 1.47), Pâ =â .63], and stent thrombosis [RR 1.13, 95% CI (0.80, 1.57), Pâ =â .49] between the 2 groups.CONCLUSION:
In patients undergoing implantation of a new-generation of DES, short-term (1-3 months) DAPT exhibited no inferiority compared with standard (12 months) DAPT in terms of all-cause mortality, cardiac death, myocardial infarction, stroke, and definite or probable stent thrombosis compared with standard (12 months) DAPT. However, short-term DAPT appeared superior to standard DAPT in terms of major bleeding and all bleeding.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Platelet Aggregation Inhibitors
/
Drug-Eluting Stents
/
Percutaneous Coronary Intervention
Limits:
Humans
Language:
En
Journal:
Medicine (Baltimore)
Year:
2024
Document type:
Article
Affiliation country:
China
Country of publication:
Estados Unidos