AI Article Synopsis

  • - The study analyzed the effects of short-term (≤ 6 months) versus long-term (≥ 12 months) dual antiplatelet therapy (DAPT) in 15,378 patients who underwent drug-eluting stent (DES) implantation to see which duration had better health outcomes.
  • - Results showed no significant differences in major adverse events (like death, heart attack, or strokes) between the two groups, indicating that both durations are similarly effective.
  • - However, patients on long-term DAPT experienced a higher risk of major bleeding compared to those on short-term therapy, suggesting that a shorter duration might be safer.

Article Abstract

Background: The optimal duration of dual antiplatelet therapy (DAPT) following drugeluting stent (DES) implantation remains a subject of an ongoing debate.

Methods: MEDLINE, EMBASE, Scopus and CENTRAL databases were searched for eligible randomized controlled trials (RCTs) that compared short-term (£ 6 months) DAPT with long-term (≥ 12 months) DAPT following DES implantation. The primary endpoint was a composite of all-cause mortality, myocardial infarction (MI), target vessel revascularization (TVR), stroke, or major bleeding. The secondary outcome were the individual components of the primary outcome, cardiovascular death, stent thrombosis and any bleeding episode.

Results: A total of 15,378 patients from 7 RCTs were studied. There were no statistically significant differences between the short-term and long-term DAPT groups with respect to the occurrence of the primary outcome (risk ratio [RR] 1.017; 0.872-1.186; I2 = 0%), all cause death (RR 0.896; 0.708-1.134), cardiovascular death (RR 0.924; 0.668-1.279), MI (RR 1.139; 0.887-1.461), TVR (RR 1.174; 0.916-1.505), stent thrombosis (RR 1.264; 0.786-2.032), and stroke (RR 0.876; 0.685-1.611). However, there was a statistically significant lower risk of major bleeding in the short-term DAPT group (RR 0.57; 0.36-0.90; p = 0.02). There were no statistically significant differences in the sub-group analysis of patients with diabetes and patients presenting with acute coronary syndrome, RR 1.029; 0.745-1.421 and RR 1.062; 0.785-1.438, respectively.

Conclusions: There was no difference in efficacy outcomes between short-term and long-term DAPT following DES, even among high-risk patients. However, longer duration of DAPT was found to be associated with increased risk of major bleeding.

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Source
http://dx.doi.org/10.5603/CJ.a2015.0078DOI Listing

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