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 language | English |
|---|---|
| Article number | h1618 |
| Journal | British Medical Journal |
| Volume | 350 |
| DOIs | |
| Publication status | Published - Apr 16 2015 |
Fingerprint
ASJC Scopus subject areas
- Medicine(all)
Cite this
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 journal › Article
}
TY - JOUR
T1 - Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents
T2 - Meta-analysis of randomised controlled trials
AU - Navarese, Eliano Pio
AU - Andreotti, Felicita
AU - Schulze, Volker
AU - Kolodziejczak, Michalina
AU - Bufon, Antonino
AU - Brouwer, Marc
AU - Costa, Francesco
AU - Kowalewski, Mariusz
AU - Parati, Gianfranco
AU - Lip, Gregory Y H
AU - Kelm, Malte
AU - Valgimigli, Marco
PY - 2015/4/16
Y1 - 2015/4/16
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84929462814&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84929462814&partnerID=8YFLogxK
U2 - 10.1136/bmj.h1618
DO - 10.1136/bmj.h1618
M3 - Article
C2 - 25883067
AN - SCOPUS:84929462814
VL - 350
JO - British Medical Journal
JF - British Medical Journal
SN - 0959-8146
M1 - h1618
ER -