Literature DB >> 33573571

Efficacy and Safety Outcomes of Short Duration Antiplatelet Therapy with Early Cessation of Aspirin Post Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.

Firas R Al-Obaidi1, Hayley A Hutchings2, Andy S C Yong3, Laith Alrubaiy4, Hasan Al-Farhan5, Mohammed H Al-Ali6, Tahsin Al-Kinani6, Mohammed Al-Myahi7, Hussein Al-Kenzawi7, Nazar Al-Sudani7.   

Abstract

BACKGROUND: The optimal duration of dual antiplatelet therapy is a matter of ongoing research. Clinical studies are assessing the optimal duration with the most favourable risk to benefit ratio. The efficacy of P2Y12 receptor inhibitors comparable to aspirin in preventing recurrent ischaemic events in patients with coronary artery diseases.
OBJECTIVES: To investigate the outcomes of short-duration dual antiplatelet therapy after PCI with early discontinuation of aspirin while maintaining patients on P2Y12 inhibitor through systematic review and meta-analysis of available literature.
METHODS: We systematically searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov. We included randomized controlled studies that measured clinical outcomes of efficacy (mortality and ischaemic events) and safety (bleeding) of short and standard-duration dual antiplatelet therapy. The protocol of this study was registered in the international prospective register of systematic reviews PROSPERO registry (CRD42020171468).
RESULTS: Four randomized controlled trials were included; GLOBAL LEADERS, SMARTCHOICE, STOPDAPT-2, and TWILIGHT. The total number of patients was 29,089. The safety outcomes showed a significant reduction in major bleeding events with short-duration dual antiplatelet therapy; the risk ratio was 0.61 (95% CI 0.38-0.99; z=2,00, p=0.05). There was no difference between short and standard-duration dual antiplatelet therapy regarding efficacy outcomes (all- cause death, major adverse cardiovascular events, myocardial infarction, stroke, and stent thrombosis).
CONCLUSION: Short-duration dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy after PCI is a feasible option and can be adopted, especially in patients with a high risk of bleeding. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Entities:  

Keywords:  P2Y12 inhibitor monotherapy.; Percutaneous coronary intervention; coronary artery disease; drugeluting stent; dual antiplatelet therapy; short-duration DAPT

Mesh：

Substances：

Year:  2021        PMID： 33573571      PMCID： PMC8950498          DOI： 10.2174/1573403X17666210126104053

Source DB:  PubMed          Journal:  Curr Cardiol Rev        ISSN： 1573-403X


  25 in total

1.  Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents.

Authors:  Laura Mauri; Dean J Kereiakes; Robert W Yeh; Priscilla Driscoll-Shempp; Donald E Cutlip; P Gabriel Steg; Sharon-Lise T Normand; Eugene Braunwald; Stephen D Wiviott; David J Cohen; David R Holmes; Mitchell W Krucoff; James Hermiller; Harold L Dauerman; Daniel I Simon; David E Kandzari; Kirk N Garratt; David P Lee; Thomas K Pow; Peter Ver Lee; Michael J Rinaldi; Joseph M Massaro
Journal:  N Engl J Med       Date:  2014-11-16       Impact factor: 91.245

2.  Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the Bleeding Academic Research Consortium.

Authors:  Roxana Mehran; Sunil V Rao; Deepak L Bhatt; C Michael Gibson; Adriano Caixeta; John Eikelboom; Sanjay Kaul; Stephen D Wiviott; Venu Menon; Eugenia Nikolsky; Victor Serebruany; Marco Valgimigli; Pascal Vranckx; David Taggart; Joseph F Sabik; Donald E Cutlip; Mitchell W Krucoff; E Magnus Ohman; Philippe Gabriel Steg; Harvey White
Journal:  Circulation       Date:  2011-06-14       Impact factor: 29.690

3.  Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial.

Authors:  Steven R Steinhubl; Peter B Berger; J Tift Mann; Edward T A Fry; Augustin DeLago; Charles Wilmer; Eric J Topol
Journal:  JAMA       Date:  2002-11-20       Impact factor: 56.272

4.  Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study.

Authors:  S R Mehta; S Yusuf; R J Peters; M E Bertrand; B S Lewis; M K Natarajan; K Malmberg; H Rupprecht; F Zhao; S Chrolavicius; I Copland; K A Fox
Journal:  Lancet       Date:  2001-08-18       Impact factor: 79.321

5.  Benefits of short-term or prolonged as compared to standard 1 year DAPT in patients with acute coronary syndrome treated with drug-eluting stents: a meta-analysis of 9 randomized trials.

Authors:  Monica Verdoia; Elvin Kedhi; Harry Suryapranata; Giacomo Frati; Giuseppe Biondi-Zoccai; Giuseppe De Luca
Journal:  J Thromb Thrombolysis       Date:  2020-08       Impact factor: 2.300

Review 6.  Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: a pooled analysis of individual-patient datasets from clinical trials.

Authors:  Francesco Costa; David van Klaveren; Stefan James; Dik Heg; Lorenz Räber; Fausto Feres; Thomas Pilgrim; Myeong-Ki Hong; Hyo-Soo Kim; Antonio Colombo; Philippe Gabriel Steg; Thomas Zanchin; Tullio Palmerini; Lars Wallentin; Deepak L Bhatt; Gregg W Stone; Stephan Windecker; Ewout W Steyerberg; Marco Valgimigli
Journal:  Lancet       Date:  2017-03-11       Impact factor: 79.321

Review 7.  Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: conceptual evolution based on emerging evidence.

Authors:  Tullio Palmerini; Gregg W Stone
Journal:  Eur Heart J       Date:  2016-01-21       Impact factor: 29.983

8.  Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI.

Authors:  C Michael Gibson; Roxana Mehran; Christoph Bode; Jonathan Halperin; Freek W Verheugt; Peter Wildgoose; Mary Birmingham; Juliana Ianus; Paul Burton; Martin van Eickels; Serge Korjian; Yazan Daaboul; Gregory Y H Lip; Marc Cohen; Steen Husted; Eric D Peterson; Keith A Fox
Journal:  N Engl J Med       Date:  2016-11-14       Impact factor: 91.245

9.  Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-label, randomised superiority trial.

Authors:  Pascal Vranckx; Marco Valgimigli; Peter Jüni; Christian Hamm; Philippe Gabriel Steg; Dik Heg; Gerrit Anne van Es; Eugene P McFadden; Yoshinobu Onuma; Cokky van Meijeren; Ply Chichareon; Edouard Benit; Helge Möllmann; Luc Janssens; Maurizio Ferrario; Aris Moschovitis; Aleksander Zurakowski; Marcello Dominici; Robert Jan Van Geuns; Kurt Huber; Ton Slagboom; Patrick W Serruys; Stephan Windecker
Journal:  Lancet       Date:  2018-08-27       Impact factor: 79.321

10.  Aspirin Versus Clopidogrel Monotherapy for the Treatment of Patients with Stable Coronary Artery Disease: A Systematic Review and Meta-Analysis.

Authors:  Jun Yuan; Guang Ma Xu; Jiawang Ding
Journal:  Adv Ther       Date:  2019-06-01       Impact factor: 3.845
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