Short- Versus Long-TermDual Antiplatelet Therapy AfterDrug-Eluting Stent Implantation
JACC cardiovasc. interv
; 65(11): 1092-1102, 2015. ilus
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1064062
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
Randomized controlled trials comparing short- (#6 months) with long-term ($1 year) dual antiplatelettherapy (DAPT) after drug-eluting stent(s) (DES) placement have been insufficiently powered to detect significantdifferences in the risk of major adverse cardiac events (MACE).OBJECTIVES This study sought to compare clinical outcomes between short- (#6 months) and long-term (1 year)DAPT and among 3 months, 6 months, and 1 year of DAPT post-DES placement by performing an individual patient datapairwise and network meta-analysis.METHODS Randomized controlled trials comparing DAPT durations after DES placement were searched through theMEDLINE, EMBASE, and Cochrane databases and in international meeting proceedings. The primary study outcomewas 1-year risk of MACE (cardiac death, myocardial infarction, or definite/probable stent thrombosis).RESULTS Four trials including 8,180 randomized patients were identified. At 1-year follow-up, short-term DAPT wasassociated with similar rates of MACE (hazard ratio [HR] 1.11; 95% confidence interval [CI] 0.86 to 1.43; p » 0.44), butsignificantly lower rates of bleeding (HR 0.66; 95% CI 0.46 to 0.94; p » 0.03) versus prolonged DAPT. Comparableresults were apparent in the landmark period between DAPT discontinuation and 1-year follow-up (for MACE HR 1.20;95% CI 0.77 to 1.89; p » 0.42) (for bleeding HR 0.44; 95% CI 0.21 to 0.91; p » 0.03). There were no significantdifferences in 1-year rates of MACE among 3-month versus 1-year DAPT, 6-month versus 1-year DAPT, or 3-month versus6-month DAPT.CONCLUSIONS Compared with prolonged DAPT, short-term DAPT is associated with similar rates of MACE but lowerrates of bleeding after DES placement.
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Collection:
National databases
/
Brazil
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Thrombosis
/
Stents
/
Drug-Eluting Stents
Type of study:
Controlled clinical trial
Language:
English
Journal:
JACC cardiovasc. interv
Year:
2015
Document type:
Article
Institution/Affiliation country:
Department of Internal Medicine, Seoul National University Hospital/KR
/
Erasmus Medical Center/NL
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Isntituto Dante Pazzanese de Cardiologia/BR
/
New York Presbyterian Hospital/US
/
Oxford Heart Center/GB
/
Sapienza University of Rome/IT
/
Severance Cardiovascular Hospital and Science Institute, Yonsei University College of Medicine/KR
/
University of Bologna/IT
/
Vascular Center and Harvard Medical School/US