Efficacy of Short-term Dual Antiplatelet Therapy after Implantation of Second-generation Drug-eluting Stents: A Meta-analysis and Systematic Review.
- Author:
Peisen HUANG
1
;
Yuan YU
1
;
Xikun HAN
1
;
Yuejin YANG
1
Author Information
1. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Medical College, Beijing 100037, China.
- Publication Type:Journal Article
- MeSH:
Drug-Eluting Stents;
Humans;
Myocardial Infarction;
chemically induced;
Platelet Aggregation Inhibitors;
adverse effects;
therapeutic use;
Randomized Controlled Trials as Topic;
Stroke;
chemically induced;
Thrombosis;
chemically induced;
Time Factors
- From:
Chinese Medical Sciences Journal
2017;32(1):1-12
- CountryChina
- Language:English
-
Abstract:
Objective The benefit of short-term dual antiplatelet therapy (DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap, we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents.Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT (≤6 months) published before March 3, 2016. The efficacy endpoints included the incidence of all-cause death, myocardial infarction, cerebrovascular accidents, and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed.Results We included 5 trials that randomized 9473 participants (49.8%, short-term DAPT duration vs. 50.2%, standard duration). A total of 9445 (99.7%) patients reported the efficacy endpoints, and the safety endpoint was available from 4 studies (n=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration (≥12 months) [risk ratio (RR) 0.96; 95% confidence intervals (CI), 0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death, myocardial infarction, cerebrovascular accidents, or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT (RR 0.53; 95% CI, 0.29-0.96), significant publication bias was found when accessing the safety endpoint of the 4 studies (Egger's test, P=0.009).Conclusions The efficacy of short-term DAPT was comparable with that of standard duration DAPT. DAPT less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation.
