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BMJ Publishing Group, BMJ, apr16 25(350), p. h1618-h1618

DOI: 10.1136/bmj.h1618

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

Journal article published in 2015 by Eliano Pio Navarese ORCID, Felicita Andreotti, Volker Schulze, M. Kolodziejczak, M. Ko odziejczak, Michalina Kołodziejczak, Antonino Buffon, Marc Brouwer, Francesco Costa, A. Bufon, Mariusz Kowalewski, Gianfranco Parati, Gregory Yh H. Lip, Marco Valgimigli, Malte Kelm
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

OBJECTIVE: To assess the benefits and risks of short term (12 months) dual antiplatelet therapy (DAPT) versus standard 12 month therapy, following percutaneous coronary intervention with drug eluting stents. DESIGN: Meta-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 METHODS: Trials comparing short term (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. RESULTS: 10 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); P12 months) could be considered. The increase in all cause but not cardiovascular death with extended DAPT requires further investigation.