Safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention: A systematic review and meta-analysis
Background: Optimal duration of dual antiplatelet therapy (DAPT) in patients undergoing complex percutaneous coronary intervention (PCI) remains under investigation. Our aim is to compare shortened (≤3 months) DAPT with longer DAPT in patients undergoing complex PCIs. Methods: Three major databases...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Hellenic Journal of Cardiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1109966623000210 |
| _version_ | 1827940263367016448 |
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| author | Anastasios Apostolos Dimitrios Chlorogiannis Georgios Vasilagkos Konstantinos Katsanos Konstantinos Toutouzas Adel Aminian Dimitrios Alexopoulos Periklis Davlouros Grigorios Tsigkas |
| author_facet | Anastasios Apostolos Dimitrios Chlorogiannis Georgios Vasilagkos Konstantinos Katsanos Konstantinos Toutouzas Adel Aminian Dimitrios Alexopoulos Periklis Davlouros Grigorios Tsigkas |
| author_sort | Anastasios Apostolos |
| collection | DOAJ |
| description | Background: Optimal duration of dual antiplatelet therapy (DAPT) in patients undergoing complex percutaneous coronary intervention (PCI) remains under investigation. Our aim is to compare shortened (≤3 months) DAPT with longer DAPT in patients undergoing complex PCIs. Methods: Three major databases (MEDLINE, Cochrane Central Register of Controlled Trials, and Scopus) were screened. The primary endpoint was major bleedings as they are defined by the Bleeding Academic Research Consortium (BARC) 3–5. The secondary endpoints were major adverse cardiovascular events, all-cause and cardiovascular mortality, myocardial infarction, stroke, and stent thrombosis. Results: Five studies were included in our analysis, with a total of 9,115 patients. Our meta-analysis met its primary endpoint, as abbreviated DAPT significantly reduced major bleedings by 43% (95% confidence intervals: 0.35–0.93). Ischemic events and mortality were not affected by the shortening of DAPT. Conclusion: Shortened DAPT significantly reduced the odds of major bleedings in patients undergoing complex PCI without increasing the ischemic events or mortality. Thus, it could be considered a safe and feasible option in such patients. |
| first_indexed | 2024-03-13T09:06:37Z |
| format | Article |
| id | doaj.art-35a3c6a38d0d46089b76c3acea08efbe |
| institution | Directory Open Access Journal |
| issn | 1109-9666 |
| language | English |
| last_indexed | 2024-03-13T09:06:37Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hellenic Journal of Cardiology |
| spelling | doaj.art-35a3c6a38d0d46089b76c3acea08efbe2023-05-28T04:08:41ZengElsevierHellenic Journal of Cardiology1109-96662023-05-01713341Safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention: A systematic review and meta-analysisAnastasios Apostolos0Dimitrios Chlorogiannis1Georgios Vasilagkos2Konstantinos Katsanos3Konstantinos Toutouzas4Adel Aminian5Dimitrios Alexopoulos6Periklis Davlouros7Grigorios Tsigkas8Department of Cardiology, Faculty of Medicine, University of Patras, University Hospital of Patras, Patras, Greece; First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, GreeceDepartment of Cardiology, Faculty of Medicine, University of Patras, University Hospital of Patras, Patras, GreeceDepartment of Cardiology, Faculty of Medicine, University of Patras, University Hospital of Patras, Patras, GreeceDepartment of Interventional Radiology, Faculty of Medicine, University of Patras, University Hospital of Patras, Patras, GreeceFirst Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, GreeceDepartment of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, BelgiumSecond Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, GreeceDepartment of Cardiology, Faculty of Medicine, University of Patras, University Hospital of Patras, Patras, GreeceDepartment of Cardiology, Faculty of Medicine, University of Patras, University Hospital of Patras, Patras, Greece; Corresponding author. Department of Cardiology, Faculty of Medicine, University of Patras, University Hospital of Patras, Patras, Greece.Background: Optimal duration of dual antiplatelet therapy (DAPT) in patients undergoing complex percutaneous coronary intervention (PCI) remains under investigation. Our aim is to compare shortened (≤3 months) DAPT with longer DAPT in patients undergoing complex PCIs. Methods: Three major databases (MEDLINE, Cochrane Central Register of Controlled Trials, and Scopus) were screened. The primary endpoint was major bleedings as they are defined by the Bleeding Academic Research Consortium (BARC) 3–5. The secondary endpoints were major adverse cardiovascular events, all-cause and cardiovascular mortality, myocardial infarction, stroke, and stent thrombosis. Results: Five studies were included in our analysis, with a total of 9,115 patients. Our meta-analysis met its primary endpoint, as abbreviated DAPT significantly reduced major bleedings by 43% (95% confidence intervals: 0.35–0.93). Ischemic events and mortality were not affected by the shortening of DAPT. Conclusion: Shortened DAPT significantly reduced the odds of major bleedings in patients undergoing complex PCI without increasing the ischemic events or mortality. Thus, it could be considered a safe and feasible option in such patients.http://www.sciencedirect.com/science/article/pii/S1109966623000210Dual antiplatelet therapyComplex percutaneous coronary interventionsBifurcationsChronic total occlusionPCI |
| spellingShingle | Anastasios Apostolos Dimitrios Chlorogiannis Georgios Vasilagkos Konstantinos Katsanos Konstantinos Toutouzas Adel Aminian Dimitrios Alexopoulos Periklis Davlouros Grigorios Tsigkas Safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention: A systematic review and meta-analysis Hellenic Journal of Cardiology Dual antiplatelet therapy Complex percutaneous coronary interventions Bifurcations Chronic total occlusion PCI |
| title | Safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention: A systematic review and meta-analysis |
| title_full | Safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention: A systematic review and meta-analysis |
| title_fullStr | Safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention: A systematic review and meta-analysis |
| title_full_unstemmed | Safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention: A systematic review and meta-analysis |
| title_short | Safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention: A systematic review and meta-analysis |
| title_sort | safety and efficacy of shortened dual antiplatelet therapy after complex percutaneous coronary intervention a systematic review and meta analysis |
| topic | Dual antiplatelet therapy Complex percutaneous coronary interventions Bifurcations Chronic total occlusion PCI |
| url | http://www.sciencedirect.com/science/article/pii/S1109966623000210 |
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