Efficacy and safety of short‐term dual antiplatelet therapy (≤6 months) after percutaneous coronary intervention for acute coronary syndrome: A systematic review and meta‐analysis of randomized controlled trials. Issue 11 (20th November 2018)

• Record Type: Journal Article
• Authors: Misumida, Naoki; Abo‐Aly, Mohamed; Kim, Sun Moon; Ogunbayo, Gbolahan O.; Abdel‐Latif, Ahmed; Ziada, Khaled M.
• Is Part Of: Clinical cardiology. Volume 41:Issue 11(2018)
• Page Start: 1455
• Page End: 1462
• Publication Date: 2018-11-20
• Subjects: acute coronary syndrome -- dual antiplatelet therapy -- percutaneous coronary intervention -- stent thrombosis; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.23075
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract : Background: Patients who undergo percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) are at increased risk for subsequent ischemic events. Hypothesis: Short‐term dual antiplatelet therapy (DAPT) (≤6 months) is inferior to standard or long‐term DAPT in patients who undergo PCI for ACS events. Methods: We conducted a systematic review and meta‐analysis of randomized controlled trials that compared short‐term (≤6 months) to long‐term (≥12 months) DAPT after PCI for ACS. We searched MEDLINE, EMBASE, SCOPUS, and the Cochrane Central Register of Controlled Trials database. Results: Ten randomized controlled trials, including a total of 12 696 patients, met our inclusion criteria. For short‐term DAPT, duration of therapy ranged from 3 to 6 months, while long‐term DAPT ranged from 12 to 24 months. The majority of studies used clopidogrel and second‐generation drug‐eluting stents. No statistically significant difference was found between short‐term and long‐term DAPT with regard to myocardial infarction (odds ratio 1.21; 95% confidence interval 0.94‐1.57; P = 0.14), stent thrombosis (odds ratio 1.54; 95% confidence interval 1.00‐2.38; P = 0.052), or major bleeding events (odds ratio 0.74; 95% confidence interval 0.49‐1.11; P = 0.14). There was no significant difference in all‐cause mortality, cardiac death, or net adverse cardiac and cerebrovascular events. Conclusions: Our meta‐analysis demonstrated that short‐term DAPT (<6 months) after PCI for ACS was not associated with increased risk of myocardial infarction or stent thrombosis when compared to long‐term DAPT.