Event Title

One month is not inferior to prolonged dual antiplatelet therapy after PCI with drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials

Session

Medicine and Nursing

Description

Aim: The aim of this meta-analysis was to evaluate the safety of 1-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug eluting stents (DES), followed by aspirin or a P2Y12 receptor inhibitor based on the available evidence.

Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL and ClinicalTrials.gov databases search identified 4 RCTs of 27,131 patients who underwent PCI with DES which compared 1-month vs. >1-month DAPT. The primary endpoint was major bleeding and co-primary endpoint stent thrombosis. Secondary endpoints included all-cause mortality, myocardial infarction (MI), stroke and major adverse clinical events (MACE).

Results: Compared to >1 month DAPT, the 1 month DAPT was associated with similar rate of major bleeding (OR=0.74, 95%CI: 0.51 to 1.04, p=0.11, I2=67%), stent thrombosis (OR=1.10, 95%CI: 0.82 to 1.47, p=0.53, I2=0.0%), similar risk for all-cause mortality (OR=0.89, 95%CI: 0.77 to 1., p=0.14, I2=0%), CV death (OR=0.80, 95%CI: 0.55 to 1.60, p=0.24, I2=0.0%), MI (OR=1.02, 95%CI: 0.87 to 1.19, p=0.81, I2=0.0%) and stroke (OR=0.76, 95%CI: 0.54 to 1.08, p=0.13, I2=29%). The risk of MACE was lower risk of MACE was lower (OR=0.84, 95%CI: 0.73 to 0.97, p=0.02, I2=36%) in the 1-month DAPT compared to the >1-month DAPT. Only patients with stable CAD had lower risk of MACE with 1-month DAPT (OR=0.81, 95%CI: 0.67 to 0.98, p=0.03, I2=21%) compared to > 1-month DAPT.

Conclusion: This meta-analysis proved non-inferiority of 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor compared to longer term DAPT in patients undergoing PCI with DES.

Proceedings Editor

Edmond Hajrizi

ISBN

978-9951-550-47-5

Location

UBT Kampus, Lipjan

Start Date

30-10-2021 12:00 AM

End Date

30-10-2021 12:00 AM

DOI

10.33107/ubt-ic.2021.215

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Oct 30th, 12:00 AM Oct 30th, 12:00 AM

One month is not inferior to prolonged dual antiplatelet therapy after PCI with drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials

UBT Kampus, Lipjan

Aim: The aim of this meta-analysis was to evaluate the safety of 1-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug eluting stents (DES), followed by aspirin or a P2Y12 receptor inhibitor based on the available evidence.

Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL and ClinicalTrials.gov databases search identified 4 RCTs of 27,131 patients who underwent PCI with DES which compared 1-month vs. >1-month DAPT. The primary endpoint was major bleeding and co-primary endpoint stent thrombosis. Secondary endpoints included all-cause mortality, myocardial infarction (MI), stroke and major adverse clinical events (MACE).

Results: Compared to >1 month DAPT, the 1 month DAPT was associated with similar rate of major bleeding (OR=0.74, 95%CI: 0.51 to 1.04, p=0.11, I2=67%), stent thrombosis (OR=1.10, 95%CI: 0.82 to 1.47, p=0.53, I2=0.0%), similar risk for all-cause mortality (OR=0.89, 95%CI: 0.77 to 1., p=0.14, I2=0%), CV death (OR=0.80, 95%CI: 0.55 to 1.60, p=0.24, I2=0.0%), MI (OR=1.02, 95%CI: 0.87 to 1.19, p=0.81, I2=0.0%) and stroke (OR=0.76, 95%CI: 0.54 to 1.08, p=0.13, I2=29%). The risk of MACE was lower risk of MACE was lower (OR=0.84, 95%CI: 0.73 to 0.97, p=0.02, I2=36%) in the 1-month DAPT compared to the >1-month DAPT. Only patients with stable CAD had lower risk of MACE with 1-month DAPT (OR=0.81, 95%CI: 0.67 to 0.98, p=0.03, I2=21%) compared to > 1-month DAPT.

Conclusion: This meta-analysis proved non-inferiority of 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor compared to longer term DAPT in patients undergoing PCI with DES.