Next Article in Journal
Long-Term Trajectories in Weight and Health Outcomes Following Multidisciplinary Publicly Funded Bariatric Surgery in Patients with Clinically Severe Obesity (≥ 3 Associated Comorbidities): A Nine-Year Prospective Cohort Study in Australia
Previous Article in Journal
Factors Modulating COVID-19: A Mechanistic Understanding Based on the Adverse Outcome Pathway Framework
 
 
Systematic Review

The Optimal Strategy of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention with Drug-Eluting Stent

State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
*
Authors to whom correspondence should be addressed.
Academic Editor: Tommaso Gori
J. Clin. Med. 2022, 11(15), 4465; https://doi.org/10.3390/jcm11154465
Received: 29 June 2022 / Revised: 20 July 2022 / Accepted: 26 July 2022 / Published: 31 July 2022
(This article belongs to the Section Cardiology)
Objective: To test the optimal strategy of dual antiplatelet therapy (DAPT) after implantation of drug-eluting stents (DESs) according to specific DAPT time and subsequent monotherapy. Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, and Web of Science to identify randomized controlled trials (RCTs). Six DAPT strategies were compared: 1-month DAPT followed by P2Y12 inhibitor monotherapy, 3-month DAPT followed by P2Y12 inhibitor monotherapy, 3-month DAPT followed by aspirin monotherapy, 6-month DAPT followed by aspirin monotherapy, 12-month DAPT, and >12-month DAPT. Pooled odd ratios (ORs) with 95% credible intervals (CrIs) were calculated to summarize the effect of each strategy tested. Results: We identified 24 RCTs containing 81,405 patients. In comparison with 12-month DAPT, 3-month DAPT followed by P2Y12 inhibitor monotherapy reduced net clinical events (OR: 0.72; CrI: 0.55–0.94). Major bleeding (OR: 0.57; CrI: 0.34–1.00) was marginally decreased without impact on ischemic events (OR: 0.93; CrI: 0.68–1.29). Moreover, the benefits of 3-month DAPT (P2Y12 inhibitor) were consistent for male patients with acute coronary disease, young age, complex lesion, single-vessel disease, low body mass index, and without diabetes. Although >12-month DAPT was associated with a lower risk of myocardial infarction (OR: 0.67; CrI: 0.51–0.93), the risk of major bleeding (OR: 1.70; CrI: 1.10–2.70) was increased. Conclusion: Among patients treated with DESs, 3-month DAPT followed by P2Y12 inhibitor monotherapy may be the optimal antiplatelet strategy, while DAPT beyond 1 year reduces myocardial infarction at the expense of increased major bleeding. View Full-Text
Keywords: percutaneous coronary intervention; drug-eluting stents; dual antiplatelet therapy; P2Y12 inhibitor percutaneous coronary intervention; drug-eluting stents; dual antiplatelet therapy; P2Y12 inhibitor
Show Figures

Figure 1

MDPI and ACS Style

Hu, M.; Gao, X.; Yang, J.; Yang, Y. The Optimal Strategy of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention with Drug-Eluting Stent. J. Clin. Med. 2022, 11, 4465. https://doi.org/10.3390/jcm11154465

AMA Style

Hu M, Gao X, Yang J, Yang Y. The Optimal Strategy of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention with Drug-Eluting Stent. Journal of Clinical Medicine. 2022; 11(15):4465. https://doi.org/10.3390/jcm11154465

Chicago/Turabian Style

Hu, Mengjin, Xiaojin Gao, Jingang Yang, and Yuejin Yang. 2022. "The Optimal Strategy of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention with Drug-Eluting Stent" Journal of Clinical Medicine 11, no. 15: 4465. https://doi.org/10.3390/jcm11154465

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop