Efficacy and Safety of Short-Term Dual Antiplatelet Therapy in East Asians: A Systematic Review and a Meta-Analysis of Randomized Clinical Trials
| Autor: | Ying Ma, Zhi-Lu Wang, Nan Bai, Ying Niu, Yao-Sheng Shang, Peng-Yu Zhong |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
animal structures Myocardial Infarction Hemorrhage Cochrane Library law.invention Percutaneous Coronary Intervention Asian People Randomized controlled trial law Internal medicine Humans Medicine In patient Myocardial infarction Stroke Randomized Controlled Trials as Topic Pharmacology business.industry Incidence (epidemiology) Thrombosis medicine.disease Treatment Outcome Meta-analysis Drug Therapy Combination Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors Major bleeding |
| Zdroj: | Journal of Cardiovascular Pharmacology. 79:264-272 |
| ISSN: | 0160-2446 |
| DOI: | 10.1097/fjc.0000000000001181 |
| Popis: | The optimal duration of dual antiplatelet therapy (DAPT) for patients implanted with new-generation drug-eluting stents in East Asians is currently still controversial. The purpose of this meta-analysis was to investigate the efficacy and safety of short-term DAPT in patients with those. In this study, randomized controlled trials from PubMed, EMBASE, and Cochrane Library were searched to compare the efficacy and safety of short-term DAPT (6 months or less) with long-term DAPT (12 months or more) in patients implanted with new-generation drug-eluting stents in East Asian from inception to September 2020. The primary efficacy outcome was all-cause death, the primary safety outcome was major bleeding, and the secondary outcomes included cardiovascular death, myocardial infarction, definite or possible stent thrombosis, and stroke. A total of 6 randomized controlled trials with 15,688 patients met inclusion criteria; there were no significant differences in the incidence of all-cause death [risk ratio (RR), 1.03; 0.76-1.39; P = 0.856)], cardiovascular death (RR, 0.83; 0.55-1.24; P = 0.361), myocardial infarction (RR, 0.97; 0.72-1.31; P = 0.853), definite or possible stent thrombosis (RR, 1.52; 0.83-2.78; P = 0.170), and stroke (RR, 0.90; 0.61-1.31; P = 0.574) between short-term and long-term DAPTs. However, there was a significant difference in the risk of major bleeding (RR, 0.64; 0.49-0.85; P = 0.002) between the 2 groups. Compared with long-term DAPT, the short-term DAPT can reduce the risk of major bleeding without increasing the risk of death or ischemia for East Asians (Registered by PROSPERO, CRD42020213266). |
| Databáze: | OpenAIRE |
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