Key result
Short-term DAPT cuts major bleeding ~35% versus 12-month therapy after PCI with DES.
Why the study?
This study aimed to evaluate the safety and effectiveness of short-term (3-6 months) dual antiplatelet therapy compared to long-term (12 months) dual antiplatelet therapy after percutaneous coronary intervention.
Does short-term DAPT (3-6 months) reduce bleeding without increasing ischemic events compared to long-term DAPT (12 months) in patients after PCI with DES?
Meta-Analysis (n=24,278)
Does short-term DAPT (3-6 months) reduce bleeding without increasing ischemic events compared to long-term DAPT (12 months) in patients after PCI with DES?
Effect estimate: HR 0.65 (95% CI 0.48-0.89)
Short-term DAPT (3-6 months) significantly reduces bleeding risks without increasing ischemic events or mortality compared to 12-month DAPT in patients undergoing PCI with DES, including those with ACS.
May favor short-term DAPT to reduce bleeding after DES-PCI; leaves ischemic safety open amid mixed meta-analysis findings.
Background This article aimed to evaluate the safety and effectiveness of short-term (3–6 months) dual antiplatelet therapy (DAPT) compared to long-term (12 months) DAPT. Methods We searched PubMed, Embase, Cochrane Library, and Web of Science for all the randomized controlled trials which compared the different durations of DAPT after the percutaneous coronary intervention within ten years before January 2021. The safety endpoint included major bleeding and any bleeding. The efficacy endpoints included all causes of death, cardiac death, myocardial infarction, definite or probable stent thrombosis, target vessel revascularization, and stroke. The hazard ratio and 95% confidence interval were abstracted. Result 11 trials and 24242 patients were finally included in this meta-analysis. Short-term DAPT was associated with a reduced risk of major bleeding [HR 0.65, 95%CI 0.48–0.89] and any bleeding [HR 0.64, 95%CI 0.53–0.79] compared with long-term DAPT. No significant differences in the risks of other endpoints were observed. In acute coronary syndrome, short-term DAPT was associated with a lower risk of major bleeding [HR 0.57, 95%CI 0.37–0.87]. Conclusion Compared with long-term DAPT, short-term DAPT reduced bleeding after PCI with DES. Besides, short-term DAPT was also feasible and safely applicable if clinically required even in ACS patients.
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Yang et al. (2022) conducted a meta-analysis in Patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) (n=24,278). Short-term dual antiplatelet therapy (DAPT) vs. Long-term DAPT was evaluated on Major bleeding (HR 0.65, 95% CI 0.48-0.89). Short-term dual antiplatelet therapy (3-6 months) reduced the risk of major bleeding (HR 0.65) compared to 12-month therapy in patients after percutaneous coronary intervention with drug-eluting stents.
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