دورية أكاديمية
Vascular Pharmacology / Optimal duration and combination of antiplatelet therapies following percutaneous coronary intervention: a meta-analysis
| العنوان: | Vascular Pharmacology / Optimal duration and combination of antiplatelet therapies following percutaneous coronary intervention: a meta-analysis |
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| المؤلفون: | Siller-Matula, Jolanta M., Gelbenegger, Georg, Erari-Canyurt, Ummahan, Grafeneder, Jürgen, Jilma, Bernd, Lesiak, Maciej, Komosa, Anna, De Caterina, Raffaele, Postula, Marek |
| بيانات النشر: | Elsevier |
| سنة النشر: | 2021 |
| المجموعة: | MedUni Vienna ePub (Medzinische Universität Wien) |
| مصطلحات موضوعية: | Dual antiplatelet therapy, Aspirin, P2Y12 inhibitor, Clopidogrel, Prasugrel, Ticagrelor |
| جغرافية الموضوع: | UMW:14604, UMW:14605, UMW:14571 |
| الوصف: | Introduction The ideal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) is still unknown. In this meta-analysis, we aimed to compare very short-term (1–3 months), short-term (6 months), standard-term (12 months) and long-term (>12 months) DAPT durations for efficacy and safety. Methods Overall DAPT comparisons were classified as “any shorter-term”/”any longer-term” DAPT. The primary outcome was a composite of major adverse cardiovascular events (MACE: non-fatal myocardial infarction, non-fatal stroke and cardiovascular death). The primary safety outcome was major bleeding. Results Twenty-six studies comprising 103.394 patients were included. Compared with standard-term DAPT duration, very short-term DAPT duration with subsequent drop of aspirin (RR 1.06, 95% CI, 0.95–1.18, p = 0.26) or drop of the P2Y12 inhibitor (RR 0.92, 95% CI, 0.72-1.16, p = 0.47) was not associated with a higher risk of MACE. Any longer-term compared with any shorter-term DAPT durations led to a significantly lower risk of MACE (RR 0.88, 95% CI, 0.81–0.96, p = 0.002), but a significantly higher risk of BARC 3-5 major bleeding events (RR 1.63, 95% CI, 1.22–2.17, p = 0.001). In the ACS subgroup receiving prasugrel or ticagrelor but not clopidogrel, any longer-term DAPT duration was associated with a significantly lower risk of MACE compared to any shorter-term DAPT duration (RR 0.84, 95% CI, 0.77–0.92, p = 0.0001). Conclusion DAPT may be shortened to 1-3 months in patients with low ischemic but high bleeding risk followed by aspirin or P2Y12 monotherapy. Prasugrel or ticagrelor based DAPT may be extended to >12 months in case of high ischemic and low bleeding risk. PROSPERO registration no CRD42020163719. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text/html |
| اللغة: | English |
| تدمد: | 1879-3649 |
| العلاقة: | vignette : https://repositorium.meduniwien.ac.at/titlepage/urn/urn:nbn:at:at-ubmuw:3-40371/128Test; urn:nbn:at:at-ubmuw:3-40371; https://resolver.obvsg.at/urn:nbn:at:at-ubmuw:3-40371Test; local:99146176255603331; system:AC16265313 |
| DOI: | 10.1016/j.vph.2021.106858 |
| الإتاحة: | https://doi.org/10.1016/j.vph.2021.106858Test https://resolver.obvsg.at/urn:nbn:at:at-ubmuw:3-40371Test |
| حقوق: | cc-by_4 |
| رقم الانضمام: | edsbas.C76896A3 |
| قاعدة البيانات: | BASE |
| تدمد: | 18793649 |
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| DOI: | 10.1016/j.vph.2021.106858 |