Evidence map›Paper›PMID 40861557›Full record

ReviewCureus2025

Comparative Efficacy and Safety of P2Y12 Inhibitor Monotherapy Versus Dual Antiplatelet Therapy in Patients Following Percutaneous Coronary Intervention (PCI): A Systematic Review.

Muhammad Khubaib Ejaz, Mohsin Khan, Nouman Anthony, Saima M Khan, Mihir Nikalje, Marwah Shah, Maleeha Anum, Taj Rajan Jacob Metharayil, Aaqif Sarooj Rasheed, Fathima Ruqaiya Mohmed Amzath

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Muhammad Khubaib EjazEmergency Medicine, Gondal Medical Complex, Gujranwala, Pakistan.
Mohsin KhanInternal Medicine, Rehman Medical Institute, Peshawar, PAK.
Nouman AnthonyGeneral Medicine, Rehman Medical Institue, Peshawar, PAK.
Saima M KhanInternal Medicine, Peshawar Medical College, Peshawar, PAK.
Mihir NikaljeInternal Medicine, Walsall Manor Hospital, Walsall, GBR.
Marwah ShahMedicine, Holy Family Hospital, Dhaka, BGD.
Maleeha AnumInternal Medicine, Jinnah Sindh Medical University, Karachi, PAK.
Taj Rajan Jacob MetharayilAcute Medicine, Walsall Manor Hospital, Walsall, GBR.
Aaqif Sarooj RasheedGeneral Medicine, Vitebsk State Medical University, Vitebsk, BLR.
Fathima Ruqaiya Mohmed AmzathGeneral Medicine, Vitebsk State Medical University, Vitebsk, BLR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Dual antiplatelet therapy (DAPT) is the standard approach for preventing ischemic events following percutaneous coronary intervention (PCI); however, the associated bleeding risk has led to growing interest in P2Y12 inhibitor monotherapy after an initial DAPT period. This systematic review evaluates the efficacy and safety of monotherapy with ticagrelor, clopidogrel, or prasugrel following one to three months of initial DAPT, compared to prolonged DAPT regimens. A comprehensive literature search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identifying randomized controlled trials (RCTs) and high-quality comparative studies published within the last five years. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool for RCTs and the Newcastle-Ottawa Scale (NOS) for post-hoc analyses. Primary outcomes included major adverse cardiovascular events (MACE) and clinically significant bleeding. Monotherapy was associated with a lower incidence of major bleeding (hazard ratio (HR) range: 0.35-0.66) while maintaining comparable ischemic outcomes, with reported MACE HRs ranging from 0.54 to 1.14. Ticagrelor monotherapy showed consistent bleeding reduction, particularly in high-risk populations, whereas clopidogrel demonstrated similar cardiovascular efficacy and a favorable safety profile in select cohorts. Efficacy and safety outcomes varied across studies depending on the agent used and patient characteristics, and moderate between-study heterogeneity was observed in trial design, populations, and outcome definitions. These findings support the use of individualized antiplatelet strategies, with P2Y12 inhibitor monotherapy emerging as a viable option for reducing bleeding risk without compromising ischemic protection in appropriately selected post-PCI patients.

Indexed as

bleeding riskcardiovascular outcomesclopidogreldual antiplatelet therapyp2y12 inhibitor monotherapypercutaneous coronary interventionprasugrelticagrelor

Identifiers

PMID40861557
PMCPMC12377639

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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.