Evidence map›Paper›PMID 41649579›Full record

SynthesisEuropean journal of clinical pharmacology2026

Clopidogrel versus aspirin monotherapy following dual antiplatelet therapy after percutaneous coronary intervention: an updated meta-analysis of 162,829 patients.

Mohammed A Elbahloul, Ahmed Mansour, Amr Galal, Walaa M Moawad, Manar Khaled, Ahmed Wahdan Kasem, Eman E Labeeb, Islam Y Elgendy

Abstract readComparative StudyMeta-Analysis
PubMed Full text at PMC Publisher
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Synthesis in European journal of clinical pharmacology, 2026. 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

8 authors.

Mohammed A Elbahloul *Faculty of Medicine, Kafr El-Shaikh University, Kafr El Sheikh, Egypt. mohammedayman1233056@gmail.com.
Ahmed Mansour *Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Amr GalalFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Walaa M MoawadFaculty of Medicine, Fayoum University, El Fayoum, Egypt.
Manar KhaledFaculty of Medicine, Fayoum University, El Fayoum, Egypt.
Ahmed Wahdan KasemFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Eman E LabeebFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Islam Y ElgendyDivision of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) remains a cornerstone for preventing ischemic events; however, the optimal long-term single antiplatelet therapy after completion of DAPT remains unclear. We aimed to compare clopidogrel and aspirin monotherapy after completion of the standard duration of DAPT.

methodsA systematic search was conducted on PubMed, Scopus, Cochrane Library, and Web of Science from inception to April 2025. We included randomized clinical trials and observational studies that compared aspirin versus clopidogrel monotherapy after completion of standard-duration DAPT. The primary and co-primary outcomes were major adverse cardiovascular events (MACE) and major bleeding, respectively. Using random-effects models, outcomes were expressed as risk ratios (RR) or hazard ratios (HR) with 95% confidence intervals (CI).

resultsTen studies, comprising 162,829 patients, were included. Clopidogrel was significantly associated with a lower risk of MACE (HR: 0.72, 95% CI: 0.66–0.79) and net adverse clinical events (NACE) (RR: 0.86, 95% CI: 0.73–0.99) at a weighted mean follow-up of 3.2 years. Major bleeding showed no significant difference between clopidogrel and aspirin (RR: 0.85, 95% CI: 0.60–1.21). Moreover, there was no difference between clopidogrel and aspirin in all-cause mortality, myocardial infarction, revascularization, stroke, or all bleeding.

conclusionAmong patients who underwent PCI, clopidogrel monotherapy after standard DAPT was associated with a lower incidence of MACE and NACE compared with aspirin monotherapy, without increasing the bleeding risk.

Indexed as

AspirinClopidogrelDual Anti-Platelet TherapyPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsDrug Therapy, CombinationHemorrhageHumansAspirinClopidogrelPlatelet Aggregation InhibitorsAspirinBleedingClopidogrelDual antiplatelet therapyMajor adverse cardiovascular eventsPercutaneous coronary intervention

Identifiers

PMID41649579
PMCPMC12881014

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Registered trials

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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.