Meta Analysis of Dual Antiplatelet Therapy≤6 Months and Dual Antiplatelet Therapy≥12 Months in Patients After Drug-eluting Stent Implantation
10.3969/j.issn.1000-3614.2015.07.006
- VernacularTitle:药物洗脱支架置入后≤6个月与≥12个月双联抗血小板治疗的Meta分析
- Author:
Si PANG
;
Haibo JIA
;
Yaojun ZHANG
;
Shunyi SHI
;
Daorong PAN
;
Xiaoyun CHEN
;
Xiaomin REN
;
Hao ZHU
;
Wen WU
;
Shaoliang CHEN
- Publication Type:Journal Article
- Keywords:
Dual antiplatelet therapy;
Drug eluting stents;
Coronary artery disease;
Randomized clinical trial;
Meta-analysis
- From:
Chinese Circulation Journal
2015;(7):639-643
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To systematically review the safety and efifciency for dual antiplatelet therapy (DAPT) ≤ 6 months and DAPT ≥ 12 months in patients after drug eluting stent (DES) implantation. Methods: We collected the data for randomized clinical trials for DAPT ≤ 6 months and DAPT ≥ 12 months in patients after DES implantation up to 2015-01 by searching the literatures of PubMed, EMBASE, Cochrane Library, Scopus and Chinese literature database, and meanwhile collected the relevant reporting cases from both domestic and international cardiovascular conferences for this study. There were 2 investigators independently conducted the literature screening, data extraction and quality evaluation, Meta analysis was performed with STATA 12.0 software. Results: A total of 15,378 patients from 7 eligible studies were enrolled and the patients were divided into 2 groups: DAPT ≤ 6 months group,n=7672 and DAPT ≥ 12 months group,n=7706. Meta analysis indicated that DAPT ≤ 6 months could effectively reduce the major bleeding (OR=0.58, 95% CI 0.37-0.91,P=0.017). While the other incidences between 2 groups were similar as all cause death (OR=0.90, 95% CI 0.73-1.11,P=0.314), cardiac death (OR=0.93, 95% CI 0.70-1.24,P=0.617), myocardial infarction (OR=1.13, 95% CI 0.91-1.41,P=0.275), in stent thrombosis (OR=1.21, 95% CI 0.79-1.85,P=0.382) and cerebrovascular accidents (OR=1.00, 95% CI 0.66-1.51,P=1.000). Conclusion: The incidence rates of cardiovascular and cerebrovascular events are similar in patients with DAPT ≤ 6 months and DAPT ≥ 12 months after DES implantation. DAPT ≤ 6 month had the lower risk of bleeding, which is rather suitable for the patients received new generation of DES, with higher risk of bleeding, lower risk of thrombosis and with poor compliance to medication; however, the large and randomized clinical trials are needed to make ifnal conclusion.
