Efficacy and safety of ticagrelor monotherapy following a brief DAPT vs. prolonged 12-month DAPT in ACS patients post-PCI: a meta-analysis of RCTs.

Autor: Qamar U; Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan., Naeem F; Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan., Maqsood MT; Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan., Khan MZ; Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan., Imtiaz Z; Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan., Saeed F; Department of Rheumatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA., Gupta N; Department of Cardiology, Kirk Kerkorian School of Medicine at the, University of Nevada, Las Vegas, USA., Brohi FZ; Department of Cardiology, Western Michigan University, Kalamazoo, MI, USA., Mkpozi C; Department of Internal Medicine and Department of Cardiology, West Virginia University, 1 Medical Ctr Dr., Morgantown, WV, 26506, USA., Sattar Y; Department of Internal Medicine and Department of Cardiology, West Virginia University, 1 Medical Ctr Dr., Morgantown, WV, 26506, USA. mdyasarsattar@gmail.com.
Jazyk: angličtina
Zdroj: European journal of clinical pharmacology [Eur J Clin Pharmacol] 2024 Dec; Vol. 80 (12), pp. 1871-1882. Date of Electronic Publication: 2024 Sep 12.
DOI: 10.1007/s00228-024-03747-w
Abstrakt: Background: As per current guidelines, acute coronary syndrome (ACS) patients who undergo percutaneous coronary intervention (PCI) should be started on dual antiplatelet therapy (DAPT) for a period of 12 months.
Objective: To assess the efficacy and safety of brief DAPT (up to 3 months) succeeded by ticagrelor monotherapy compared with a 12-month DAPT in ACS patients following PCI.
Methods: We systematically searched Cochrane, Embase, and PubMed to find relevant randomized clinical trials. Examined outcomes included the incidence of major adverse cerebrovascular and cardiovascular events (MACCE), bleeding events, and the composite incidence of net adverse clinical events (NACE).
Results: Our primary analysis included 21,927 ACS patients from six RCTs. Our pooled results indicate that following PCI in individuals with ACS, brief DAPT followed by ticagrelor did not increase the risk of MACCE (OR 0.92, 95% CI 0.79-1.07) but significantly reduced the risk of minor or major bleeding (OR 0.52, 95% CI 0.44-0.62) and NACE (OR 0.71, 95% CI 0.59-0.86) compared with a long-term DAPT within a follow-up of 12 months.
Conclusion: Brief DAPT followed by ticagrelor monotherapy is superior to a 12-month DAPT in offering a net clinical advantage in ACS patients following PCI.
Competing Interests: Declarations Ethics approval The present meta-analysis does not involve direct data collection from human subjects or animals. All data used in this study were obtained from previously published and publicly available sources, adhering to the ethical guidelines of the respective studies. No identifiable patient information is presented in this meta-analysis. Competing interests The authors declare no competing interests.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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