SynthesisDrug design, development and therapy2018
Short-versus long-term dual antiplatelet therapy after second-generation drug-eluting stent implantation: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Drug design, development and therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundThe optimal dual antiplatelet therapy (DAPT) duration after second-generation drug-eluting stent (DES) implantation remains unclear. We aim to evaluate the efficacy and safety of short-term (≤6 months) and long-term (≥12 months) DAPT after second-generation DES implantation.
methodsRandomized controlled trials (RCTs) were searched in PubMed, the Cochrane Library, the Embase and ClinicalTrials.gov in the English language. The endpoints included all-cause mortality, cardiac death, non-cardiac death, myocardial infarction (MI), stent thrombosis (ST), stroke, all bleeding, and major bleeding. The effect estimate was expressed by using the hazard ratio (HR) with 95% CI and random effect models.
resultsSeven RCTs with 13,571 patients were included in this study. In terms of survival endpoints, there was no significant difference in all-cause mortality (HR: 0.91; 95% CI: 0.71-1.17), cardiac death (HR: 0.93; 95% CI: 0.67-1.29), and non-cardiac death (HR: 0.89; 95% CI: 0.62-1.28) in the 2 groups. Moreover, there was no significant difference in ischemic outcomes, including MI (HR: 1.15; 95% CI: 0.91-1.45), ST (HR: 1.11; 95% CI: 0.75-1.66), and stroke (HR: 0.85; 95% CI: 0.53-1.35) in the 2 groups. In terms of bleeding endpoints, there was no significant difference in all bleeding (HR: 0.81; 95% CI: 0.64-1.04) and major bleeding (HR: 0.82; 95% CI: 0.49-1.36) in the 2 groups. The subgroup analysis showed that the proportion of patients with acute coronary syndrome was not associated with the benefit of long-term versus short-term DAPT.
conclusionShort-term DAPT is not inferior to long-term DAPT in patients implanted with second-generation DES.
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