P2Y12 inhibitor monotherapy significantly reduced major adverse cardiovascular events (OR 0.73) compared to aspirin monotherapy following dual antiplatelet therapy in patients after percutaneous coronary intervention.
Meta-Analysis (n=29,756)
Does P2Y12 inhibitor monotherapy reduce major adverse cardiovascular events compared to aspirin monotherapy in patients who have completed dual antiplatelet therapy following percutaneous coronary intervention?
P2Y12 inhibitor monotherapy following DAPT post-PCI significantly reduces MACE, repeat revascularization, and stroke compared to aspirin monotherapy, without increasing major bleeding.
Effect estimate: OR 0.73 (95% CI 0.64-0.84)
p-value: p=<0.0001
Introduction P2Y12 inhibitor monotherapy has emerged as a potential alternative to aspirin following dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary intervention (PCI), but the optimal choice remains uncertain. Methods A systematic literature search compared P2Y12 inhibitors with aspirin post PCI. A random-effects model pooled odds ratios (ORs) with 95% confidence intervals (CIs) for outcomes. Results Seven studies (29,756 patients) were included. P2Y12 inhibitors significantly reduced MACE compared to aspirin OR = 0.73; 95% CI: 0.64–0.84. No significant difference was observed in all-cause mortality OR = 0.90; 95% CI: 0.77–1.05, cardiac death OR = 0.86; 95% CI: 0.68–1.09, major bleeding OR = 1.06; 95% CI: 0.67–1.68, MI OR = 0.78; 95% CI: 0.56–1.08, or stent thrombosis OR = 0.71; 95% CI: 0.41–1.22. P2Y12 inhibitors significantly reduced repeat revascularisation OR = 0.83; 95% CI: 0.73–0.94 and stroke OR = 0.63; 95% CI: 0.48–0.81. Conclusions P2Y12 inhibitors may be a safer, more effective alternative to aspirin alone after PCI.
Kazmi et al. (Mon,) conducted a meta-analysis in Ischaemic heart disease post-percutaneous coronary intervention (n=29,756). P2Y12 inhibitor monotherapy (clopidogrel or ticagrelor) vs. Aspirin monotherapy was evaluated on Major adverse cardiovascular events (MACE) (OR 0.73, 95% CI 0.64-0.84, p=<0.0001). P2Y12 inhibitor monotherapy significantly reduced major adverse cardiovascular events (OR 0.73) compared to aspirin monotherapy following dual antiplatelet therapy in patients after percutaneous coronary intervention.