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Zhang, Junyan, Chen, Zhongxiu, Li, Chen, Wang, Duolao 
ORCID: https://orcid.org/0000-0003-2788-2464, He, Siyu, Luo, Chaoyu, Luo, Fangbo and He, Yong
(2022)
'Short dual antiplatelet therapy in patients with high bleeding risk undergoing percutaneous coronary intervention: a systematic review and meta-analysis.'. Coronary Artery Disease, Vol 33, Issue 7, pp. 580-589.
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Coronary artery disease-Short dual antiplatelet therapy in patients with high bleeding risk undergoing percutaneous coronary intervention.pdf - Accepted Version Download (746kB) | Preview |
Abstract
Background
The efficacy and safety of an abbreviated duration of dual antiplatelet therapy (DAPT) in patients with high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI) (PCI-HBR patients) remain controversial.
Methods
The Cochrane Library, PubMed, EMBASE, and Ovid MEDLINE databases were searched. Studies that enrolled PCI-HBR patients as research subjects, compared different DAPT durations, and reported incidences of major adverse cardiac events (MACE) and net adverse clinical events (NACE) in PCI-HBR patients were obtained. The studies were stratified according to the DAPT duration (1, 3, and 6 months), and meta-analysis was subsequently performed.
Results
Nine studies (10 cohorts) were included in the meta-analysis. Compared with those who received DAPT for >1 month, PCI-HBR patients who received the 1-month DAPT regimen had comparable risks of NACE and MACE. Compared to those who received DAPT for >3 months, the risk of developing MACE in PCI-HBR patients who received the 3-month DAPT was not increased; however, the risk of ischemic stroke and stent thrombosis increased. Compared to those who received DAPT for >6 months, patients who received the 6-month DAPT had a reduction in the risk of major bleeding without an increase in NACE and MACE.
Conclusions
Shortening the DAPT regimen to 1 or 6 months did not increase the risk of MACE, and the 6-month DAPT regimen reduced the risk of major bleeding. However, the 3-month DAPT regimen increased the risk of ischemic stroke. Thus, shortened DAPT reduced the risk of MACE and bleeding, with a small absolute increase in ischemic strokes.
| Item Type: | Article |
|---|---|
| Subjects: | WG Cardiovascular System > Heart. Heart Diseases > WG 200 General works WH Hemic and Lymphatic Systems > WH 20 Research (General) |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1097/MCA.0000000000001180 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 13 Dec 2022 10:44 |
| Last Modified: | 01 Nov 2023 04:12 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/21314 |
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