Dual-antiplatelet therapy beyond 12 months did not reduce the composite of death and nonfatal MI compared with discontinuation at 12 months (HR 0.91; 95% CI 0.75-1.10).
Meta-Analysis
Does the duration of dual-antiplatelet therapy affect the risk of death and nonfatal MI in patients following drug-eluting stent implantation?
A duration of 6 to 12 months of dual-antiplatelet therapy appears optimal after drug-eluting stent implantation, as shorter durations increase ischemic risk and longer durations do not significantly reduce death or nonfatal MI.
Hazard Ratio: 0.91 (95% CI 0.75–1.1)
Optimal duration of dual-antiplatelet therapy (DAPT) following drug-eluting stent (DES) implantation remains uncertain. The aim of this study was to perform a meta-analysis of trials evaluating the effect of DAPT duration on long-term clinical outcomes after DES implantation. The authors searched OvidMEDLINE, EMBASE, and the Cochrane Library for both randomized controlled trials and nonrandomized studies that evaluated DAPT duration on long-term clinical outcomes after DES implantation. The end point was the cumulative incidence of the composite of all-cause death and nonfatal myocardial infarction (MI) at maximum follow-up. Quantitative analysis was performed to estimate the pooled hazard ratios (HRs) for the effect of DAPT duration. The pooled effect of DAPT discontinuation before 6 months significantly increased risk of death and nonfatal MI (HR, 1.46; 95% confidence interval, 1.18-1.80), but DAPT beyond 12 months did not reduce the incidence of the composite end point compared with drug discontinuation at 12 months (HR, 0.91; 95% confidence interval, 0.75-1.10). In conclusion, the current evidence suggests that 6 to 12 months of DAPT may be optimal after DES implantation.
Zhang et al. (Sat,) conducted a meta-analysis in Drug-eluting stent (DES) implantation. Dual-antiplatelet therapy (DAPT) beyond 12 months vs. DAPT discontinuation at 12 months was evaluated on Cumulative incidence of the composite of all-cause death and nonfatal myocardial infarction (MI) at maximum follow-up (HR 0.91, 95% CI 0.75-1.10). Dual-antiplatelet therapy beyond 12 months did not reduce the composite of death and nonfatal MI compared with discontinuation at 12 months (HR 0.91; 95% CI 0.75-1.10).
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