Evidence map›Paper›PMID 25883067›Full record

SynthesisBMJ (Clinical research ed.)2015

Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents: meta-analysis of randomised controlled trials.

Eliano Pio Navarese, Felicita Andreotti, Volker Schulze, Michalina Kołodziejczak, Antonino Buffon, Marc Brouwer, Francesco Costa, Mariusz Kowalewski, Gianfranco Parati, Gregory Y H Lip and 2 more

Erratum issued Registry-linked trialOpen access · hybridAbstract readComparative StudyMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT04135989 (Randomized 2x2 Factorial Trial Comparing the Cre8 Amphilimus-sirolimus Eluting Stent vs. the Synergy Everolimus-eluting Stent and a Personalized vs. Standard Duration of Dual Antiplatelet Therapy in All-comers Patients Undergoing Percutaneous Coronary Intervention), which is not on this map. Cited by 105 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
105citing papers in PubMed, 21 pooled it
42.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04135989 phase4unknown statusnot on this mapstarted 2020, after this paper: background citation

Randomized 2x2 Factorial Trial Comparing the Cre8 Amphilimus-sirolimus Eluting Stent vs. the Synergy Everolimus-eluting Stent and a Personalized vs. Standard Duration of Dual Antiplatelet Therapy in All-comers Patients Undergoing Percutaneous Coronary Intervention

TypeinterventionalSponsorFederico II UniversityRan2020 to 2024Enrolled2,106ConditionsCoronary Artery Disease, Acute Coronary Syndrome, Chronic Coronary Syndrome, Myocardial InfarctionArmsPercutaneous coronary intervention with implantation of amphilimus-eluting stents for coronary artery disease., Percutaneous coronary intervention with implantation of everolimus-eluting stents for coronary artery disease., Personalized DAPT duration, Standard DAPT duration
3 · Its place in the literature

Who cites it

105 citing papers in PubMed, 21 syntheses or guidelines pooled it, 329 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. P2YBMJ (Clinical research ed.) · 2025
    Pooled it
  4. Guideline
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Mortality after bleeding versus myocardial infarction in coronary artery disease: a systematic review and meta-analysis.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021
    Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Atencion primaria · 2018
    Guideline
  14. Pooled it
  15. Cost-effectiveness of percutaneous coronary intervention with cobalt-chromium everolimus eluting stents versus bare metal stents: Results from a patient level meta-analysis of randomized trials.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2017
    Pooled it
  16. Pooled it
  17. Pooled it
  18. Pooled it
  19. Pooled it
  20. Pooled it

45 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 5 countries.

Eliano Pio NavareseDepartment of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, 40225 Düsseldorf, Germany Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany eliano.navarese@alice.it.
Felicita AndreottiSystematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany Department of Cardiovascular Science, Catholic University, Rome, Italy.
Volker SchulzeDepartment of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, 40225 Düsseldorf, Germany Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany.
Michalina KołodziejczakDepartment of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, 40225 Düsseldorf, Germany Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń, Poland.
Antonino BuffonDepartment of Cardiovascular Science, Catholic University, Rome, Italy Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany.
Marc BrouwerDepartment of Cardiology, University Medical Centre St Radboud, Nijmegen, Netherlands Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany.
Francesco CostaDepartment of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands.
Mariusz KowalewskiSystematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany Department of Cardiology, 10th Military Research Hospital and Polyclinic, Bydgoszcz, Poland.
Gianfranco ParatiDepartment of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, University of Milan-Bicocca, Milan, Italy.
Gregory Y H LipDepartment of Cardiology, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany.
Malte KelmDepartment of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, 40225 Düsseldorf, Germany Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany.
Marco ValgimigliDepartment of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands.
Heinrich Heine University Düsseldorf · DEUniversità Cattolica del Sacro Cuore · ITBirmingham City Hospital · GBRadboud University Nijmegen · NLUniversity of Milano-Bicocca · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the benefits and risks of short term (<12 months) or extended (>12 months) dual antiplatelet therapy (DAPT) versus standard 12 month therapy, following percutaneous coronary intervention with drug eluting stents.

designMeta-analysis of randomised controlled trials. DATA SOURCES: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Cochrane Library, and major congress proceedings, searched from 1 January 2002 to 16 February 2015. REVIEW

methodsTrials comparing short term (<12 months) or extended (>12 months) DAPT regimens with standard 12 month duration of therapy. Primary outcomes were cardiovascular mortality, myocardial infarction, stent thrombosis, major bleeding, and all cause mortality.

results10 randomised controlled trials (n=32,287) were included. Compared to 12 month DAPT, a short term course of therapy was associated with a significant reduction in major bleeding (odds ratio 0.58 (95% confidence interval 0.36 to 0.92); P=0.02) with no significant differences in ischaemic or thrombotic outcomes. Extended versus 12 month DAPT yielded a significant reduction in the odds of myocardial infarction (0.53 (0.42 to 0.66); P<0.001) and stent thrombosis (0.33 (0.21 to 0.51); P<0.001), but more major bleeding (1.62 (1.26 to 2.09); P<0.001). All cause but not cardiovascular death was also significantly increased (1.30 (1.02 to 1.66); P=0.03).

conclusionsCompared with a standard 12 month duration, short term DAPT (<12 months) after drug eluting stent implementation yields reduced bleeding with no apparent increase in ischaemic complications, and could be considered for most patients. In selected patients with low bleeding risk and very high ischaemic risk, extended DAPT (>12 months) could be considered. The increase in all cause but not cardiovascular death with extended DAPT requires further investigation.

Indexed as

Drug-Eluting StentsPercutaneous Coronary InterventionAspirinCombined Modality TherapyCoronary Artery DiseaseDrug Administration ScheduleDrug Therapy, CombinationHemorrhageHumansModels, StatisticalMyocardial InfarctionPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsRandomized Controlled Trials as TopicTreatment OutcomeAspirinPlatelet Aggregation InhibitorsPurinergic P2Y Receptor Antagonists

Identifiers

PMID25883067
PMCPMC4410620
OpenAlexW2122594641

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.