TY  - BOOK
AU  - Ben-Dor, Itsik
TI  - Safety and Efficacy of Ultra Short-duration Dual Antiplatelet Therapy After Percutaneous Coronary Interventions: A Meta-analysis of Randomized Controlled Trials. [Review]
SN  - 0146-2806
PY  - 2022///
KW  - *Ischemic Stroke
KW  - *Myocardial Infarction
KW  - *Percutaneous Coronary Intervention
KW  - *Thrombosis
KW  - Drug Therapy, Combination
KW  - Hemorrhage
KW  - Humans
KW  - Platelet Aggregation Inhibitors
KW  - Randomized Controlled Trials as Topic
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
KW  - Meta-Analysis
KW  - Review
N2  - Dual antiplatelet therapy (DAPT) is required after percutaneous coronary intervention (PCI) to reduce stent thrombosis, but DAPT increases bleeding risks. The optimal duration of DAPT that provides the maximum protective ischemic effect along with the minimum bleeding risk is unclear. This is the first meta-analysis comparing outcomes for 1-month versus longer DAPT strategies following PCI. We searched PubMed, Cochrane, and ClinicalTrials.gov databases (from inception to October 2021) for randomized controlled trials that compared 1-month duration vs > 1-month duration of DAPT following PCI. We used a random-effects model to calculate risk ratio (RR) with 95% confidence interval (CI). The co-primary outcomes for study selection were all-cause mortality, major bleeding, and stent thrombosis. Secondary outcomes included myocardial infarction (MI), cardiovascular mortality, ischemic stroke and target vessel revascularization. A total of five randomized controlled trials were included [n=29,355; 1-month DAPT(n=14,662) vs > 1-month DAPT (n=14,693)]. There was no statistically significant difference between the two groups in terms of all-cause mortality (RR 0.89; 95% CI 0.78-1.03; P=0.12) and stent thrombosis (RR 1.07; 95% CI 0.80-1.43; P=0.65). Similarly, there were no significant differences in MI, cardiovascular mortality, ischemic stroke, and target vessel revascularization. The rate of major bleeding was significantly lower in the group treated with DAPT for 1-month (RR 0.74; 95% CI 0.56-0.99, P=0.04). There is no difference in all-cause mortality, cardiovascular mortality, MI, stent thrombosis, ischemic stroke, and target vessel revascularization with 1-month of DAPT following PCI with contemporary drug eluting stents compared to longer DAPT duration. Copyright © 2022 Elsevier Inc. All rights reserved
UR  - https://dx.doi.org/10.1016/j.cpcardiol.2022.101295
ER  -