Evidence map›Paper›PMID 38809372›Full record

SynthesisDrugs2024

Sex-Based Outcomes of Dual-Antiplatelet Therapy After Percutaneous Coronary Intervention: A Pairwise and Network Meta-Analysis.

Thomas A Agbaedeng, Jean Jacques Noubiap, Kirsty A Roberts, Derek P Chew, Peter J Psaltis, Azmeraw T Amare

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Drugs, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Personalized Antithrombotic Therapy After Percutaneous Coronary Intervention: A Systematic Review of Risk-Stratified Approaches.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
    Pooled it
  2. Pooled it
  3. Review
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Thomas A AgbaedengCentre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Dr, Oxford, OX3 7BN, UK. thomas.agbaedeng@outlook.com.ORCID http://orcid.org/0000-0002-4399-9139
Jean Jacques NoubiapAdelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.
Kirsty A RobertsResearch Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
Derek P ChewMonash Data Futures Institute, Monash University , Clayton, Victoria , Australia.
Peter J PsaltisAdelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.
Azmeraw T AmareAdelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough dual antiplatelet therapy (DAPT) improves the outcomes of patients undergoing percutaneous coronary intervention (PCI), sex-specific differences in efficacy and safety of DAPT remain unresolved. We compared sex differences for DAPT outcomes and DAPT durations (1-3 months [short-term], 6 months [mid-term], and >12 months [extended] vs. 12 months).

methodsWe searched databases through 31 December 2023 for trials reporting DAPT after PCI. The endpoints were major adverse cardiovascular and cerebrovascular events (MACCE), net adverse clinical and cerebrovascular events (NACCE), and any bleeding. Extracted data were pooled in a frequentist network and pairwise, random-effects meta-analysis.

resultsTwenty-two trials (99,591 participants, 25.2% female) were included. Female sex was significantly associated with a higher 1-year MACCE risk (hazard ratio 1.14 [95% confidence interval 1.02-1.28]) and bleeding (1.13 [1.00-1.28]), but not NACCE (1.12 [0.96-1.31]). In sub-analyses, the association between female sex and MACCE was related to use of clopidogrel as the second antiplatelet agent (1.11 [1.03-1.20]), whereas higher bleeding events were related to newer P2Y12 inhibitors (P2Y12i) (1.58 [1.01-2.46]). For DAPT duration, short-term DAPT followed by P2Y12i monotherapy was non-inferior for MACCE in females and males (0.95 [95% CI 0.83-1.10; and 0.96 [0.80-1.16]) but tended to be superior in males for NACCE versus 12-month DAPT (0.96 [0.91-1.01]); mid-term DAPT tended to be associated with a lower bleeding risk in males (0.43 [0.17-1.09]).

conclusionsFemale sex is associated with higher MACCE and bleeding when newer P2Y12i agents are used. Short-term DAPT followed by P2Y12i monotherapy is safe and effective in both sexes undergoing PCI. CLINICAL TRIALS REGISTRATION: PROSPERO ID: CRD42021278663.

Indexed as

Dual Anti-Platelet TherapyHemorrhagePercutaneous Coronary InterventionPlatelet Aggregation InhibitorsClopidogrelFemaleHumansMaleSex FactorsTreatment OutcomeClopidogrelPlatelet Aggregation Inhibitors

Identifiers

PMID38809372

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.