C-56 | Outcomes of P2Y12 inhibitor monotherapy Versus Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: A Meta-Analysis

12 months of dual antiplatelet therapy (DAPT), encompassing aspirin and a P2Y12 inhibitor, remains the conventional treatment for minimizing the risk of stent thrombosis after percutaneous coronary intervention (PCI). Given the significant decrease in incidences of stent thrombosis along with concerns of increased risk of bleeding with DAPT, we aimed to evaluate clinical outcomes of P2Y12 inhibitor monotherapy versus DAPT regimens after PCI. We searched multiple databases for studies comparing P2Y12 inhibitor monotherapy versus DAPT regimens in patients who underwent PCI. We used a common-effect model to calculate risk ratios (RR) with 95% confidence intervals in R studio. Outcomes assessed were all-cause mortality, cardiovascular mortality, stent thrombosis, myocardial infarction (MI), revascularization, and stroke. A total of 5 studies were identified consisting of 32143 patients of which 16056 received P2Y12 inhibitor monotherapy and 16087 received DAPT. There were no significant differences between P2Y12 inhibitor monotherapy and DAPT in all-cause mortality (RR 0.88; 95% CI 0.76 - 1.02), cardiovascular mortality (RR 0.75; 95% CI 0.46 - 1.24), stent thrombosis (RR 1; 95% CI 0.75 - 1.34), MI (RR: 0.97; 95% CI 0.84 - 1.11), revascularization (RR: 0.96; 95% CI 0.88 - 1.05), and stroke (RR 0.94; 95% CI 0.72 - 1.22). This meta-analysis found P2Y12 inhibitor monotherapy was associated with similar outcomes compared to DAPT after PCI. Further studies are warranted to confirm our findings.