Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents: Meta-analysis of randomised controlled trials

Eliano Pio Navarese, Felicita Andreotti, Volker Schulze, Michalina Kolodziejczak, Antonino Bufon, Marc Brouwer, Francesco Costa, Mariusz Kowalewski, Gianfranco Parati, Gregory Y H Lip, Malte Kelm, Marco Valgimigli

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To assess the benefits and risks of short term (12 months) dual antiplatelet therapy (DAPT) versus standard 12 month therapy, following percutaneous coronary intervention with drug eluting stents. DESIGN: Meta-analysis of randomised controlled trials. Data SOURCES: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Cochrane Library, and major congress proceedings, searched from 1 January 2002 to 16 February 2015. review METHODS: Trials comparing short term (12 months) DAPT regimens with standard 12 month duration of therapy. Primary outcomes were cardiovascular mortality, myocardial infarction, stent thrombosis, major bleeding, and all cause mortality. RESULTS: 10 randomised controlled trials (n=32 287) were included. Compared to 12 month DAPT, a short term course of therapy was associated with a significant reduction in major bleeding (odds ratio 0.58 (95% confidence interval 0.36 to 0.92); P=0.02) with no significant differences in ischaemic or thrombotic outcomes. Extended versus 12 month DAPT yielded a significant reduction in the odds of myocardial infarction (0.53 (0.42 to 0.66); P12 months) could be considered. The increase in all cause but not cardiovascular death with extended DAPT requires further investigation.

Original languageEnglish
Article numberh1618
JournalBritish Medical Journal
Volume350
DOIs
Publication statusPublished - Apr 16 2015

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Drug-Eluting Stents
Percutaneous Coronary Intervention
Meta-Analysis
Randomized Controlled Trials
Therapeutics
Library Science
Myocardial Infarction
Hemorrhage
Mortality
PubMed
Curriculum
Stents
Nursing
Thrombosis
Odds Ratio
Confidence Intervals
Health

ASJC Scopus subject areas

  • Medicine(all)

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Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents : Meta-analysis of randomised controlled trials. / Navarese, Eliano Pio; Andreotti, Felicita; Schulze, Volker; Kolodziejczak, Michalina; Bufon, Antonino; Brouwer, Marc; Costa, Francesco; Kowalewski, Mariusz; Parati, Gianfranco; Lip, Gregory Y H; Kelm, Malte; Valgimigli, Marco.

In: British Medical Journal, Vol. 350, h1618, 16.04.2015.

Research output: Contribution to journalArticle

Navarese, EP, Andreotti, F, Schulze, V, Kolodziejczak, M, Bufon, A, Brouwer, M, Costa, F, Kowalewski, M, Parati, G, Lip, GYH, Kelm, M & Valgimigli, M 2015, 'Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents: Meta-analysis of randomised controlled trials', British Medical Journal, vol. 350, h1618. https://doi.org/10.1136/bmj.h1618
Navarese, Eliano Pio ; Andreotti, Felicita ; Schulze, Volker ; Kolodziejczak, Michalina ; Bufon, Antonino ; Brouwer, Marc ; Costa, Francesco ; Kowalewski, Mariusz ; Parati, Gianfranco ; Lip, Gregory Y H ; Kelm, Malte ; Valgimigli, Marco. / Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents : Meta-analysis of randomised controlled trials. In: British Medical Journal. 2015 ; Vol. 350.
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