Efficacy of Short-term Dual Antiplatelet Therapy after Implantation of Second-generation Drug-eluting Stents: A Meta-analysis and Systematic Review

Huang Peisen; Yu Yuan; Han Xikun; Yang Yuejin

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Efficacy of Short-term Dual Antiplatelet Therapy after Implantation of Second-generation Drug-eluting Stents: A Meta-analysis and Systematic Review

Chinese Medical Sciences Journal Vol. 32, Issue 1, Pages: 1-12(2017)

Orginal Article | Updated：2024-04-10

- Efficacy of Short-term Dual Antiplatelet Therapy after Implantation of Second-generation Drug-eluting Stents: A Meta-analysis and Systematic Review
- Affiliations：
  
  1.1State Key Laboratory of Cardiovascular Disease
  2.2National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
- Author bio：
  
  *Corresponding author Tel: 86-10-88398760, Fax: 86-10-68351786, E-mail: yangyjfw@126.com
- Funds：
- DOI：
  CLC：
- Published Online：03 March 2016，
  
  Published：2017-04
- Accepted：
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Huang Peisen, Yu Yuan, Han Xikun, et al. Efficacy of Short-term Dual Antiplatelet Therapy after Implantation of Second-generation Drug-eluting Stents: A Meta-analysis and Systematic Review[J]. Chinese medical sciences journal, 2017, 32(1): 1-12.
DOI：

Huang Peisen, Yu Yuan, Han Xikun, et al. Efficacy of Short-term Dual Antiplatelet Therapy after Implantation of Second-generation Drug-eluting Stents: A Meta-analysis and Systematic Review[J]. Chinese medical sciences journal, 2017, 32(1): 1-12. DOI：

摘要

Abstract

Objective

The benefit of short-term dual antiplatelet therapy (DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap

we did a meta-analysis to assess the efficacy of ≤6 months

versus

≥12 months DAPT among patients with second-generation drug-eluting stents.

Methods

We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT (≤6 months) published before March 3

2016. The efficacy endpoints included the incidence of all-cause death

myocardial infarction

cerebrovascular accidents

and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed.

Results

We included 5 trials that randomized 9473 participants (49.8%

short-term DAPT duration

. 50.2%

standard duration). A total of 9445 (99.7%) patients reported the efficacy endpoints

and the safety endpoint was available from 4 studies (

=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration (≥12 months) [risk ratio (

) 0.96; 95% confidence intervals (

)

0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death

myocardial infarction

cerebrovascular accidents

or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT (

0.53; 95%

0.29-0.96)

significant publication bias was found when accessing the safety endpoint of the 4 studies (Egger’s test

=0.009).

Conclusions

The efficacy of short-term DAPT was comparable with that of standard duration DAPT. DAPT less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation.

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references

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