Why the study?
The optimal duration of DAPT after complex PCI remains under investigation.
Does one-month dual-antiplatelet therapy reduce Net Adverse Clinical Events compared to longer therapy (>3 months) in patients following complex percutaneous coronary intervention?
Does one-month dual-antiplatelet therapy reduce Net Adverse Clinical Events compared to longer therapy (>3 months) in patients following complex percutaneous coronary intervention?
A one-month duration of dual-antiplatelet therapy after complex PCI showed no significant difference in safety and efficacy endpoints compared to longer durations (>3 months).
Supports 30-day DAPT after complex PCI; extends meta-analytic safety data to higher-risk lesions.
The optimal duration of DAPT after complex PCI remains under investigation. The purpose of this systematic review and meta-analysis was to explore the safety and efficacy of a one-month therapy period versus a longer duration of DAPT after complex PCI. We systematically screened three major databases, searching for randomized controlled trials or sub-analyses of them, which compared shortened DAPT (S-DAPT), namely, one month, and longer DAPT (L-DAPT), namely, more than three months. The primary endpoint was any Net Adverse Clinical Event (NACE), and the secondary was any MACE (Major Adverse Cardiac Event), its components (mortality, myocardial infarction, stroke, and stent thrombosis), and major bleeding events. Three studies were included in the analysis, with a total of 6275 patients. Shortening DAPT to 30 days after complex PCI did not increase the risk of NACEs (OR: 0.77, 95% CI: 0.52-1.14), MACEs, mortality, myocardial infractions, stroke, or stent thrombosis. Pooled major bleeding incidence was reduced, but this finding was not statistically significant. This systematic review and meta-analysis showed that one-month DAPT did not differ compared to a longer duration of DAPT after complex PCI in terms of safety and efficacy endpoints. Further studies are still required to confirm these findings.
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Apostolos et al. (2024) studied this question.
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