Case-fatality rate of major bleeding events in patients on dual antiplatelet therapy after percutaneous coronary intervention: a systematic review and meta-analysis
Res Pract Thromb Haemost
; 6(7): 12834, Nov. 2022. graf, ilus, tab
Article
in English
| CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1411028
Responsible library:
BR79.1
ABSTRACT
BACKGROUND:
Assessment of the case-fatality rate (CFR) of major bleeding on dual antiplatelet therapy (DAPT) may improve balancing risks and benefits of different durations of DAPT following percutaneous coronary intervention (PCI).OBJECTIVES:
To determine the CFR of major bleeding in patients on DAPT after PCI and to compare rates among different durations of DAPT.METHODS:
Medline, Embase, and CENTRAL were searched from inception to August 2021 for randomized trials that reported fatal bleeding among patients who were randomized to ≥1 month of DAPT following PCI. Summary estimates for CFRs of major bleeding were calculated using the random-effects inverse-variance method. Statistical heterogeneity was evaluated using the I2 statistic.RESULTS:
Of 2777 citations obtained by the search, 15 (48%) of 31 potentially eligible studies were excluded because fatal bleeding was not reported, leaving 16 studies that were included in the analysis. Overall, there were 823 major bleeding events including 91 fatal events in 48,884 patients who were assigned to receive DAPT during study follow-up. The CFR of major bleeding was 10.8% (95% confidence interval [CI], 7.1 16.2; I2= 50%) in the entire study population, and 13.8% (95% CI, 6.527.1; I2= 28%), 11.2% (95% CI, 6.7 18.0; I2= 0%), and 5.8% (95% CI, 3.011.1; I2= 0%) in those on short-term (≤6 months; n= 16,553), standard-term (12 months; n= 19,453), and long-term DAPT (>12 months; n= 10,238), respectively.CONCLUSION:
Fatal bleeding is not reported in many studies evaluating DAPT after PCI. The CFR of major bleeding on DAPT is substantial and may be higher in the first 12 months of DAPT than during long-term DAPT.
Full text:
Available
Collection:
National databases
/
Brazil
Database:
CONASS
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Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Platelet Aggregation Inhibitors
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Drug-Eluting Stents
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Percutaneous Coronary Intervention
Type of study:
Controlled clinical trial
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Systematic review
Language:
English
Journal:
Res Pract Thromb Haemost
Year:
2022
Document type:
Article
Institution/Affiliation country:
Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School/US
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Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern/CH
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Department of Invasive Cardiology, Instituto Dante Pazzanese de Cardiologia/BR
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Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa/CA
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Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam/NL
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Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Eastern Piedmont University/IT
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Division of Cardiology, Teikyo University Hospital/JP
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University of Ottawa Heart Institute/CA