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One-Month Dual Antiplatelet Therapy Reduces Major Bleeding Compared With Longer-Term Treatment Without Excess Stent Thrombosis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
Bajraktari, Gani; Bytyçi, Ibadete; Abdyli, Genc; Ibrahimi, Pranvera; Bajraktari, Artan; Karahoda, Rona; Elezi, Shpend; Henein, Michael Y.
Afiliación
  • Bajraktari G; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo. Electronic address: gani.bajraktari@umu.se.
  • Bytyçi I; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
  • Abdyli G; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
  • Ibrahimi P; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
  • Bajraktari A; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
  • Karahoda R; Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Prague, Czech Republic.
  • Elezi S; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
  • Henein MY; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Am J Cardiol ; 227: 91-97, 2024 Sep 15.
Article en En | MEDLINE | ID: mdl-39029722
ABSTRACT
Dual antiplatelet therapy (DAPT) remains the gold standard in patients who underwent percutaneous coronary intervention (PCI). This meta-analysis aims to evaluate the clinical safety of 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor after PCI with drug-eluting stents (DES). We searched PubMed, MEDLINE, Embase, Scopus, Google Scholar, Cochrane Central Registry, and ClinicalTrials.gov databases and identified 5 randomized controlled trials with 29,831 patients who underwent PCI with DES and compared 1-month versus >1-month DAPT. The primary end point was major bleeding, and the co-primary end point was stent thrombosis. The secondary end point included all-cause mortality, cardiovascular death, myocardial infarction, stroke, and major adverse cardiovascular or cerebrovascular events. Compared with >1-month DAPT, the 1-month DAPT was associated with a lower rate of major bleeding (odds ratio [OR] 0.66, 95% confidence interval [CI] 0.45 to 0.97, p = 0.03, I2 = 71%), whereas stent thrombosis had a similar rate in both study groups (OR 1.08, 95% CI 0.81 to 1.44, p = 0.60, I2 = 0.0%). The study groups had similar risks for all-cause mortality (OR 0.89, 95% CI 0.77 to 1.04, p = 0.14, I2 = 0.0%), cardiovascular death (OR 0.84, 95% CI 0.59 to 1.19, p = 0.32, I2 = 0.0%), myocardial infarction (OR 1.04, 95% CI 0.89 to 1.21, p = 0.62, I2 = 0.0%), and stroke (OR 0.82, 95% CI 0.64 to 1.05, p = 0.11, I2 = 6%). The risk of major adverse cardiovascular or cerebrovascular events was lower (OR 0.86, 95% CI 0.76 to 0.97, p = 0.02, I2 = 25%) in the 1-month DAPT compared with >1-month DAPT. In conclusion, in patients who underwent PCI with DES, 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor reduced major bleeding with no risk of increased thrombotic risk compared with longer-term DAPT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inhibidores de Agregación Plaquetaria / Stents Liberadores de Fármacos / Intervención Coronaria Percutánea / Terapia Antiplaquetaria Doble / Hemorragia Límite: Humans Idioma: En Revista: Am J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inhibidores de Agregación Plaquetaria / Stents Liberadores de Fármacos / Intervención Coronaria Percutánea / Terapia Antiplaquetaria Doble / Hemorragia Límite: Humans Idioma: En Revista: Am J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos