Dual versus single antiplatelet therapy for patients with long-term oral anticoagulation undergoing coronary intervention: a systematic review and meta-analysis.

Figures

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  Figure 1.. Flowchart showing the study screening process.

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  Figure 2.. Forest plots of MACCE in 11 studies. (A): prospective studies; (B): retrospective studies (C): identified in this meta-analysis. AFCAS: atrial fibrillation undergoing coronary artery stenting; CI: confidence interval; ISAR-TRIPCE: intracoronary stenting and antithrombotic regimen–testing of a 6-week versus a 6-month clopidogrel treatment regimen in patients with concomitant aspirin and oral anticoagulant therapy following drug-eluting; MACCE: major adverse cardiac and cerebrovascular events; OAC: oral anticoagulation; ORBIT AF: Outcome registry for better informed treatment of atrial fibrillation; PIONEER AF-PCI: open-Label, randomized, controlled, multi-center study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vita-min K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention; REAL: registro angioplastiche emilia-romagna; SA: single antiplatelet; TT: triple therapy (warfarin + clopidogrel + aspirin); WOEST: what is the optimal antiplatelet and anticoagulant therapy in patients with oral anticoagulation and coronary stenting.

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  Figure 3.. Forest plots of risks of all-cause death in 10 studies. (A): prospective studies; (B): retrospective studies; (C): identified in this meta-analysis. AFCAS: atrial fibrillation undergoing coronary artery stenting; CI: confidence interval; ISAR-TRIPCE: intracoronary stenting and antithrombotic regimen–testing of a 6-week versus a 6-month clopidogrel treatment regimen in patients with concomitant aspirin and oral anticoagulant therapy following drug-eluting; OAC: oral anticoagulation; ORBIT AF: Outcome registry for better informed treatment of atrial fibrillation; PIONEER AF-PCI: open-Label, randomized, controlled, multi-center study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vita-min K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention; REAL: registro angioplastiche emilia-romagna; SA: single antiplatelet; TT: triple therapy (warfarin + clopidogrel + aspirin); WOEST: what is the optimal antiplatelet and anticoagulant therapy in patients with oral anticoagulation and coronary stenting.

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  Figure 4.. Forest plots of risks of MI in 9 studies. (A): prospective studies; (B): retrospective studies; (C): identified in this meta-analysis. AFCAS: atrial fibrillation undergoing coronary artery stenting; CI: confidence interval; ISAR-TRIPCE: intracoronary stenting and antithrombotic regimen–testing of a 6-week versus a 6-month clopidogrel treatment regimen in patients with concomitant aspirin and oral anticoagulant therapy following drug-eluting; MACCE: major adverse cardiac and cerebrovascular events; OAC: oral anticoagulation; ORBIT AF: Outcome registry for better informed treatment of atrial fibrillation; PIONEER AF-PCI: open-Label, randomized, controlled, multi-center study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vita-min K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention; REAL: registro angioplastiche emilia-romagna; SA: single antiplatelet; TT: triple therapy (warfarin + clopidogrel + aspirin); WOEST: what is the optimal antiplatelet and anticoagulant therapy in patients with oral anticoagulation and coronary stenting.

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  Figure 5.. Forest plots of risks of Stroke/TIA/PE in 10 studies. (A): prospective studies; (B): retrospective studies; (C): identified in this meta-analysis. AFCAS: atrial fibrillation undergoing coronary artery stenting; CI: confidence interval; ISAR-TRIPCE: intracoronary stenting and antithrombotic regimen–testing of a 6-week versus a 6-month clopidogrel treatment regimen in patients with concomitant aspirin and oral anticoagulant therapy following drug-eluting; MACCE: major adverse cardiac and cerebrovascular events; OAC: oral anticoagulation; ORBIT AF: Outcome registry for better informed treatment of atrial fibrillation; PIONEER AF-PCI: open-Label, randomized, controlled, multi-center study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vita-min K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention; REAL: registro angioplastiche emilia-romagna; SA: single antiplatelet; TT: triple therapy (warfarin+clopidogrel+aspirin); WOEST: what is the optimal antiplatelet and anticoagulant therapy in patients with oral anticoagulation and coronary stenting.

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  Figure 6.. Forest plots of risks of ST in 9 studies. (A): prospective studies; (B): identified in this meta-analysis. AFCAS: atrial fibrillation undergoing coronary artery stenting; CI: confidence interval; ISAR-TRIPCE: intracoronary stenting and antithrombotic regimen–testing of a 6-week versus a 6-month clopidogrel treatment regimen in patients with concomitant aspirin and oral anticoagulant therapy following drug-eluting; MACCE: major adverse cardiac and cerebrovascular events; OAC: oral anticoagulation; ORBIT AF: Outcome registry for better informed treatment of atrial fibrillation; PIONEER AF-PCI: open-Label, randomized, controlled, multi-center study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vita-min K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention; REAL: registro angioplastiche emilia-romagna; SA: single antiplatelet; ST: stent thrombosis; TT: triple therapy (warfarin+clopidogrel+aspirin); WOEST: what is the optimal antiplatelet and anticoagulant therapy in patients with oral anticoagulation and coronary stenting.

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  Figure 7.. Forest plots of risks of major bleeding in 12 studies. (A): prospective studies; (B): retrospective studies; (C) identified in this meta-analysis. AFCAS: atrial fibrillation undergoing coronary artery stenting; CI: confidence interval; ISAR-TRIPCE: intracoronary stenting and antithrombotic regimen–testing of a 6-week versus a 6-month clopidogrel treatment regimen in patients with concomitant aspirin and oral anticoagulant therapy following drug-eluting; MACCE: major adverse cardiac and cerebrovascular events; OAC: oral anticoagulation; ORBIT AF: Outcome registry for better informed treatment of atrial fibrillation; PIONEER AF-PCI: open-Label, randomized, controlled, multi-center study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vita-min K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention; REAL: registro angioplastiche emilia-romagna; SA: single antiplatelet; TT: triple therapy (warfarin+clopidogrel+aspirin); WOEST: what is the optimal antiplatelet and anticoagulant therapy in patients with oral anticoagulation and coronary stenting.